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Archnet-IJAR

ISSN : 2631-6862

Article publication date: 3 January 2023

Issue publication date: 7 March 2024

There has been a recently growing interest by architects in practice-based research and the impact of research. At the same time, several post-graduate architecture programmes with practice-led research agendas were founded. This shift towards architectural design research is analysed using the notions of “process-driven research”, “output-driven research” and “impact”. The study aims to investigate and unveil the link between graduate programmes and graduates with a research interest and to test the tripartite model of “process-driven research”, “output-driven research” and “impact” in the context of small architectural practices.

Design/methodology/approach

The study uses a qualitative and exploratory research approach that includes 11 in-depth interviews conducted in 2020, during the first nationwide COVID-19 lockdown in the United Kingdom (UK) selected interviews were architects representing (1) members or alumni of practice-related graduate architecture programmes in London and (2) founders of London-based small architectural practices within the last decade.

While focussing on the London context, the paper offers transferable insights for the key potentials of practice-led design research in small architectural practices and the actions that might improve research practice.

Originality/value

This paper addresses a lack of studies on how design research differs between diverse types and sizes of architectural firms, why emerging small architectural practices increasingly engage with research and how this shapes their practice. This knowledge is important to fully understanding architectural design research and its strengths or weaknesses.

• Architectural design research
• Architectural practice
• Architectural education

Acknowledgements

This paper is produced as a part of a postdoctoral research project supervised by Professor Sam Jacoby, funded by the Scientific and Technological Research Council of Turkey (TUBITAK, grant number 1059B191801865) and undertaken at the Royal College of Art, School of Architecture in London.

Aydemir, A.Z. and Jacoby, S. (2024), "Architectural design research in small practices", Archnet-IJAR , Vol. 18 No. 1, pp. 191-205. https://doi.org/10.1108/ARCH-07-2022-0142

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The Architect-Researcher: Exploring New Possibilities for the Production of Architecture

• Written by Andreea Cutieru
• Published on January 28, 2022

While research seems intrinsic to the design process, architectural research is a professional path in itself, whose purpose is to highlight scientific evidence and explore alternatives outside of pre-established norms or empirical considerations. Its purpose is to create a framework of knowledge that can inform the design to reach objectively better outcomes. The following discusses the role and state of research in architecture, some prominent areas of inquiry, and the architects or institutions that dedicate their work to these subjects.

In 2018, AIA stated that "the research available for study of architecture and buildings is disproportionate to its impact [on societies and economies] " and proposed an extensive research agenda while promoting increased investment in research and research literacy. The argument was that the way architecture addresses major technological, environmental and societal shifts "affects all levels of scale—from the individual to larger society" and thus requires research efforts at par with the implications.

Architectural Research versus Research Through Practice

Jeremy Till's canonical paper commissioned by RIBA, Architectural Research : Three Myths and One Model , argues that "architecture is a form of knowledge that can and should be developed through research", but most importantly, helps define what exactly constitutes research in architecture. In his essay, initially published in 2007, with a revised version presented in 2017, Till contradicts the idea that practice is intrinsically a form of research by saying that architecture knowledge exceeds the built object and that whatever knowledge a building contains, it is not explicitly communicated. He also critiques architecture's avoidance of research methodologies and makes a case for architectural research conducted through a paradigm specific to architecture rather than the methodologies of other fields it intersects in the process.

In his keynote lecture at KU Leuven's The Practice of Architectural Research Symposium , prof. Wilfried Wang describes architectural research as "publicly transparent, scientifically analytical and independently verifiable", thus distinguishing it from empirical ideas and assumptions stemming from daily practice. Architectural research falls under three categories: research that creates and expands knowledge, usually conducted within academia and research laboratories, applied research, designed for a specific application, transferring new pieces of knowledge into practice and project-based research.

Fields of Inquiry

Understanding how a building improves performance, influences health, or how the built environment impacts people's behaviour and cognitive functions, the potential of new technologies for architecture and construction, and material innovation are just some critical areas of study. In addition, new ideas in urbanism, studies on resilience, design interventions that reduce environmental impact, and understanding how could architecture improve equity are equally essential research needs within the field of architecture.

Neuroscience, human behaviour, health and wellbeing are currently flourishing areas of inquiry in architectural research, as the body of knowledge in these fields has expanded significantly during the last two decades. In this sense, the Academy of Neuroscience for Architecture (ANFA) explores the intersection between design and behaviour, with a mission of using neuro and cognitive science research to improve the design of the built environment. The study of architecture through these lenses has also given rise to new areas of study such as environmental neuroscience and neuroarchitecture , shaping a scientific understanding of the built environment's impact on brain processes and behaviour.

Neri Oxman and her exploration of material ecology , or Jenny Sabin and her research into the application of science and biology into architecture pursue architecture innovation through transdisciplinarity and cross breedings of different areas of expertise. MIT's now discontinued Mediated Matter Group conducted research at the intersection of computational design, digital fabrication, materials science, and synthetic biology. At the same time, new technologies, whether those used in the design of buildings such as digital fabrication or technologies used in building operations are fertile ground for architectural research. Also at MIT, the Self-Assembly Lab looks to develop self-assembly and programmable material technologies, while the Sustainable Design Lab develops tools to evaluate the environmental performance of buildings. At the University of Stuttgart, Professor Achim Menges' research focuses on developing "design processes at the intersection of morphogenetic design computation, biomimetic engineering and computer-aided manufacturing", essentially working towards developing a new design and construction paradigm.

Research within the Practice

At the same time, research doesn't reside solely in academia, as some firms bring it at the forefront of their practice. Perkins+Will goes beyond the typical preoccupations of an architecture office and publishes a peer-reviewed journal twice a year for which researchers and designers investigate topics that, although might have the potential to inform future design projects, are developed outside the ordinary practice. In addition, the firm hosts several Research Labs, where, together with academics and experts in different fields, it pursues various lines of inquiry in building technology, human experience, material performance, mobility or resilience. The topics of these studies range from the impact of adaptive working behaviour on the carbon footprint, factors that reduce noise pollution in urban spaces or creating a framework of social equity indicators. Another take on research within the practice is White Arkitketer's Research Lab , whose agenda for 2020-2023 is to explore through interdisciplinary collaborations the subject of circular architecture, investigating product flows, transformation and re-use or strategies for climate positive projects.

Academic research has the shortcoming of being somewhat hermetic. While journals like Frontiers of Architectural Research disseminate works in the field of architectural research, and prestigious universities attempt to popularize their findings, they rarely penetrate through mainstream practice. Often criticized for being self-referential and inward-looking, architectural research is slowly developing its own methodologies, serving the design process in shaping a better built environment.

This article is part of the ArchDaily Topics: Architecture Without Buildings . Every month we explore a topic in-depth through articles, interviews, news, and projects. Learn more about our ArchDaily topics . As always, at ArchDaily we welcome the contributions of our readers; if you want to submit an article or project, contact us .

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Design research in architecture: an overview

2014, Choice Reviews Online

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• Published: 18 September 2020

Senses of place: architectural design for the multisensory mind

• Charles Spence   ORCID: orcid.org/0000-0003-2111-072X 1  

Cognitive Research: Principles and Implications volume  5 , Article number:  46 ( 2020 ) Cite this article

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Traditionally, architectural practice has been dominated by the eye/sight. In recent decades, though, architects and designers have increasingly started to consider the other senses, namely sound, touch (including proprioception, kinesthesis, and the vestibular sense), smell, and on rare occasions, even taste in their work. As yet, there has been little recognition of the growing understanding of the multisensory nature of the human mind that has emerged from the field of cognitive neuroscience research. This review therefore provides a summary of the role of the human senses in architectural design practice, both when considered individually and, more importantly, when studied collectively. For it is only by recognizing the fundamentally multisensory nature of perception that one can really hope to explain a number of surprising crossmodal environmental or atmospheric interactions, such as between lighting colour and thermal comfort and between sound and the perceived safety of public space. At the same time, however, the contemporary focus on synaesthetic design needs to be reframed in terms of the crossmodal correspondences and multisensory integration, at least if the most is to be made of multisensory interactions and synergies that have been uncovered in recent years. Looking to the future, the hope is that architectural design practice will increasingly incorporate our growing understanding of the human senses, and how they influence one another. Such a multisensory approach will hopefully lead to the development of buildings and urban spaces that do a better job of promoting our social, cognitive, and emotional development, rather than hindering it, as has too often been the case previously.

Significance statement

Architecture exerts a profound influence over our well-being, given that the majority of the world’s population living in urban areas spend something like 95% of their time indoors. However, the majority of architecture is designed for the eye of the beholder, and tends to neglect the non-visual senses of hearing, smell, touch, and even taste. This neglect may be partially to blame for a number of problems faced by many in society today including everything from sick-building syndrome (SBS) to seasonal affective disorder (SAD), not to mention the growing problem of noise pollution. However, in order to design buildings and environments that promote our health and well-being, it is necessary not only to consider the impact of the various senses on a building’s inhabitants, but also to be aware of the way in which sensory atmospheric/environmental cues interact. Multisensory perception research provides relevant insights concerning the rules governing sensory integration in the perception of objects and events. This review extends that approach to the understanding of how multisensory environments and atmospheres affect us, in part depending on how we cognitively interpret, and/or attribute, their sources. It is argued that the confusing notion of synaesthetic design should be replaced by an approach to multisensory congruency that is based on the emerging literature on crossmodal correspondences instead. Ultimately, the hope is that such a multisensory approach, in transitioning from the laboratory to the real world application domain of architectural design practice, will lead on to the development of buildings and urban spaces that do a better job of promoting our social, cognitive, and emotional development, rather than hindering it, as has too often been the case previously.

Introduction

We are visually dominant creatures (Hutmacher, 2019 ; Levin, 1993 ; Posner, Nissen, & Klein, 1976 ). That is, we all mostly tend to think, reason, and imagine visually. As Finnish architect Pallasmaa ( 1996 ) noted almost a quarter of a century ago in his influential work The eyes of the skin: Architecture and the senses, architects have traditionally been no different in this regard, designing primarily for the eye of the beholder (Bille & Sørensen, 2018 ; Pallasmaa, 1996 , 2011 ; Rybczynski, 2001 ; Williams, 1980 ). Elsewhere, Pallasmaa ( 1994 , p. 29) writes that: “The architecture of our time is turning into the retinal art of the eye. Architecture at large has become an art of the printed image fixed by the hurried eye of the camera . ” The famous Swiss architect Le Corbusier ( 1991 , p. 83) went even further in terms of his unapologetically oculocentric outlook, writing that: “I exist in life only if I can see”, going on to state that: “I am and I remain an impenitent visual—everything is in the visual” and “one needs to see clearly in order to understand”. Commenting on the current situation, Canadian designer Bruce Mau put it thus: “We have allowed two of our sensory domains—sight and sound—to dominate our design imagination. In fact, when it comes to the culture of architecture and design, we create and produce almost exclusively for one sense—the visual.” (Mau, 2018 , p. 20; see also Blesser & Salter, 2007 ).

Such visual dominance makes sense or, at the very least, can be explained or accounted for neuroscientifically (Hutmacher, 2019 ; Meijer, Veselič, Calafiore, & Noppeney, 2019 ). After all, it turns out that far more of our brains are given over to the processing of what we see than to dealing with the information from any of our other senses (Gallace, Ngo, Sulaitis, & Spence, 2012 ). For instance, according to Felleman and Van Essen ( 1991 ), more than half of the cortex is engaged in the processing of visual information (see also Eberhard, 2007 , p. 49; Palmer, 1999 , p. 24; though note that others believe that the figure is closer to one third). This figure compares to something like just 12% of the cortex primarily dedicated to touch, around 3% to hearing, and less than 1% given over to the processing of the chemical senses of smell and taste. Footnote 1 Information theorists such as Zimmerman ( 1989 ) arrived at a similar hierarchy, albeit with a somewhat different weighting for each of the five main senses. In particular, Zimmermann estimated a channel capacity (in bits/s) of 10 7 for vision, 10 6 for touch, 10 5 for hearing and olfaction, and 10 3 for taste (gustation).

Figure  1 schematically illustrates the hierarchy of attentional capture by each of the senses as envisioned by Morton Heilig, the inventor of the Sensorama, the world’s first multisensory virtual reality apparatus (Heilig, 1962 ), when writing about the multisensory future of cinema in an article first published in 1955 (see Heilig, 1992 ). Nevertheless, while commentators from many different disciplines would seem to agree on vision’s current pre-eminence, one cannot help but wonder what has been lost as a result of the visual dominance that one sees wherever one looks in the world of architecture (“see” and “look” being especially apposite terms here).

Heilig ( 1992 ) ranked the order in which he believed our attention to be captured by the various senses. According to Heilig’s rankings: vision, 70%; audition, 20%; olfaction, 5%; touch, 4%; and taste, 1%. Does the same hierarchy (and weighting) apply to our appreciation of architecture, one might wonder? And is attentional capture the most relevant metric anyway?

While the hegemony of the visual (see Levin, 1993 ) is a phenomenon that appears across most aspects of our daily lives, the very ubiquity of this phenomenon certainly does not mean that the dominance of the visual should not be questioned (e.g., Dunn, 2017 ; Hutmacher, 2019 ). For, as Finnish architect and theoretician Pallasmaa ( 2011 , p. 595) notes: “Spaces, places, and buildings are undoubtedly encountered as multisensory lived experiences. Instead of registering architecture merely as visual images, we scan our settings by the ears, skin, nose, and tongue.” Elsewhere, he writes that: “Architecture is the art of reconciliation between ourselves and the world, and this mediation takes place through the senses” (Pallasmaa, 1996 , p. 50; see also Böhme, 2013 ). We will return later to question the visual dominance account, highlighting how our experience of space, as of anything else, is much more multisensory than most people realize.

Review outline

While architectural practice has traditionally been dominated by the eye/sight, a growing number of architects and designers have, in recent decades, started to consider the role played by the other senses, namely sound, touch (including proprioception, kinesthesis, and the vestibular sense), smell, and, on rare occasions, even taste. It is, then, clearly important that we move beyond the merely visual (not to mention modular) focus in architecture that has been identified in the writings of Juhani Pallasmaa and others, to consider the contribution that is made by each of the other senses (e.g., Eberhard, 2007 ; Malnar & Vodvarka, 2004 ). Reviewing this literature constitutes the subject matter of the next section. However, beyond that, it is also crucial to consider the ways in which the senses interact too. As will be stressed later, to date there has been relatively little recognition of the growing understanding of the multisensory nature of the human mind that has emerged from the field of cognitive neuroscience research in recent decades (e.g., Calvert, Spence, & Stein, 2004 ; Stein, 2012 ).

The principal aim of this review is therefore to provide a summary of the role of the human senses in architectural design practice, both when considered individually and, more importantly, when the senses are studied collectively. For it is only by recognizing the fundamentally multisensory nature of perception that one can really hope to explain a number of surprising crossmodal environmental or atmospheric interactions, such as between lighting colour and thermal comfort (Spence, 2020a ) or between sound and the perceived safety of public spaces (Sayin, Krishna, Ardelet, Decré, & Goudey, 2015 ), that have been reported in recent years.

At the same time, however, this review also highlights how the contemporary focus on synaesthetic design in architecture (see Pérez-Gómez, 2016 ) needs to be reframed in terms of the crossmodal correspondences (see Spence, 2011 , for a review), at least if the most is to be made of multisensory interactions and synergies that affect us all. Later, I want to highlight how accounts of multisensory interactions in architecture in terms of synaesthesia tend to confuse matters, rather than to clarify them. Accounting for our growing understanding of crossmodal interactions (specifically the emerging field of crossmodal correspondences research) and multisensory integration will help to explain how it is that our senses conjointly contribute to delivering our multisensory (and not just visual) experience of space. One other important issue that will be discussed later is the role played by our awareness of the multisensory atmosphere of the indoor environments in which we spend so much of our time.

Looking to the future, the hope is that architectural design practice will increasingly incorporate our growing understanding of the human senses, and how they influence one another. Such a multisensory approach will hopefully lead to the development of buildings and urban spaces that do a better job of promoting our social, cognitive, and emotional development, rather than hindering it, as has too often been the case previously. Before going any further, though, it is worth highlighting a number of the negative outcomes for our well-being that have been linked to the sensory aspects of the environments in which we spend so much of our time.

Negative health consequences of neglecting multisensory stimulation

It has been suggested that the rise in sick building syndrome (SBS) in recent decades (Love, 2018 ) can be put down to neglect of the olfactory aspect of the interior environments where city dwellers have been estimated to spend 95% of their lives (e.g., Ott & Roberts, 1998 ; Velux YouGov Report, 2018 ; Wargocki, 2001 ). Indeed, as of 2010, more people around the globe lived in cities than lived in rural areas (see UN-Habitat, 2010 and United Nations Department of Economic and Social Affairs, 2018 ). One might also be tempted to ask what responsibility, if any, architects bear for the high incidence of seasonal affective disorder (SAD) that has been documented in northern latitudes (Cox, 2017 ; Heerwagen, 1990 ; Rosenthal, 2019 ; Rosenthal et al., 1984 ). To give a sense of the problem of “light hunger” (as Heerwagen, 1990 , refers to it), Terman ( 1989 ) claimed that as many as 2 million people in Manhattan alone experience seasonal affective and behavioural changes severe enough to require some form of additional light stimulation during the winter months.

According to Pallasmaa ( 1994 , p. 34), Luis Barragán, the self-taught Mexican architect famed for his geometric use of bright colour (Gregory, 2016 ) felt that most contemporary houses would be more pleasant with only half their window surface. However, while such a suggestion might well be appropriate in Mexico, where Barragán’s work is to be found, many of us (especially those living in northern latitudes in the dark winter months) need as much natural light as we can obtain to maintain our psychological well-being. That said, Barragán is not alone in his appreciation of darkness and shadow. Some years ago, Japanese writer Junichirō Tanizaki also praised the aesthetic appeal of shadow and darkness in the native architecture of his home country in his extended essay on aesthetics, In praise of shadows (Tanizaki, 2001 ).

One of the problems with the extensive use of windows in northern climates is related to poor heat retention, an issue that is becoming all the more prominent in the era of sustainable design and global warming. One solution to this particular problem that has been put forward by a number of technology-minded researchers is simply to replace windows by the use of large screens that relay a view of nature for those who, for whatever reason, have to work in windowless offices (Kahn Jr. et al., 2008 ). However, the limited research that has been conducted on this topic to date suggests that the beneficial effects of being seated near to the window in an office building cannot easily be captured by seating workers next to such video-screens instead.

Similarly, the failure to fully consider the auditory aspects of architectural design may help to explain some part of the global health crisis associated with noise pollution interfering with our sleep, health, and well-being (Owen, 2019 ). The neglect of architecture’s fundamental role in helping to maintain our well-being is a central theme in Pérez-Gómez’s ( 2016 ) influential book Attunement: Architectural meaning after the crisis of modern science. Pérez-Gómez is the director of the History and Theory of Architecture Program at McGill University in Canada. Along similar lines, geographer J. Douglas Porteous had already noted some years earlier that: “Notwithstanding the holistic nature of environmental experience, few researchers have attempted to interpret it in a very holistic [or multisensory] manner.” (Porteous, 1990 , p. 201). Finally, here, it is perhaps also worth noting that there are even some researchers who have wanted to make a connection between the global obesity crisis and the obesogenic environments that so many of us inhabit (Lieberman, 2006 ). The poor diet of multisensory stimulation that we experience living a primary indoor life has also been linked to the growing sleep crisis apparently facing so many people in society today (Walker, 2018 ).

Designing for the modular mind

Researchers working in the field of environmental psychology have long stressed the impact that the sensory features of the built environment have on us (e.g., Mehrabian & Russell, 1974 , for an influential early volume detailing this approach). Indeed, many years ago, the famous modernist Swiss architect Le Corbusier ( 1948 ) made the intriguing suggestion that architectural forms “work physiologically upon our senses.” Inspired by early work with the semantic differential technique, researchers would often attempt to assess the approach-avoidance, active-passive, and dominant-submissive qualities of a building or urban space. This approach was based on the pleasure, arousal, and dominance (PAD) model that has long been dominant in the field. However, it is important to stress that in much of their research, the environmental psychologists took a separate sense-by-sense approach (e.g., Zardini, 2005 ).

The majority of researchers have tended to focus their empirical investigations on studying the impact of changing the stimulation presented to just one sense at a time. More often than not, in fact, they would focus on a single sensory attribute, such as, for example, investigating the consequences of changing the colour (hue) of the lighting or walls (e.g., Bellizzi, et al., 1983 ; Bellizzi & Hite, 1992 ; Costa, Frumento, Nese, & Predieri, 2018 ; Crowley, 1993 ), or else just modulating the brightness of the ambient lighting (e.g., Gal, Wheeler, & Shiv, 2007 ; Xu & LaBroo, 2014 ). Such a unisensory (and, in some cases, unidimensional) approach undoubtedly makes sense inasmuch as it may help to simplify the problem of studying how design affects us (Malnar & Vodvarka, 2004 ). What is more, such an approach is also entirely in tune with the modular approach to mind that was so popular in the fields of psychology and cognitive neuroscience in the closing decades of the twentieth century (e.g., Barlow & Mollon, 1982 ; Fodor, 1983 ). At the same time, however, it can be argued that this sense-by-sense approach neglects the fundamentally multisensory nature of mind, and the many interactions that have been shown to take place between the senses.

The visually dominant approach to research in the field of environmental psychology also means that far less attention has been given over to studying the impact of the auditory (e.g., Blesser & Salter, 2007 ; Kang et al., 2016 ; Schafer, 1977 ; Southworth, 1969 ; Thompson, 1999 ), tactile, somatosensory or embodied (e.g., Heschong, 1979 ; Pallasmaa, 1996 ; Pérez-Gómez, 2016 ), or even the olfactory qualities of the built environment (e.g., Bucknell, 2018 ; Drobnick, 2002 , 2005 ; Henshaw, McLean, Medway, Perkins, & Warnaby, 2018 ) than on the impact of the visual. Furthermore, until very recently, little consideration has been given by the environmental psychologists to the question of how the senses interact, one with another, in terms of their influence on an individual. This neglect is particularly striking given that the natural environment, the built environment, and the atmosphere of a space are nothing if not multisensory (e.g., Bille & Sørensen, 2018 ). In fact, it is no exaggeration to say that our response to the environments, in which we find ourselves, be they built or natural, is always going to be the result of the combined influence of all the senses that are being stimulated, no matter whether we are aware of their influence or not (this is a point to which we will return later).

Given that those of us living in urban environments, which as we have seen is now the majority of us, spend more than 95% of our lives indoors (Ott & Roberts, 1998 ), architects would therefore seem to bear at least some responsibility for ensuring that the multisensory attributes of the built environment work together to deliver an experience that positively stimulates the senses, and, by so doing, facilitates our well-being, rather than hinders it (see also Pérez-Gómez, 2016 , on this theme). Crucially, however, a growing body of cognitive neuroscience research now demonstrates that while we are often unaware of, or at least pay little conscious attention to the subtle sensory cues that may be conveyed by a space (e.g., Forster & Spence, 2018 ), that certainly does not mean that they do not affect us. In fact, the sensory qualities or attributes of the environment have long been known to affect our health and well-being in environments as diverse as the hospital and the home, and from the office to the gym (e.g., Spence, 2002 , 2003 , 2021 ; Spence & Keller, 2019 ). What is more, according to the research that has been published to date, environmental multisensory stimulation can potentially affect us at the social, emotional, and cognitive levels.

It can be argued, therefore, that we all need to pay rather more attention to our senses and the way in which they are being stimulated than we do at present (see also Pérez-Gómez, 2016 , on this theme). You can call it a mindful approach to the senses (Kabat-Zinn, 2005 ), Footnote 2 though my preferred terminology, coined in an industry report published almost 20 years ago, is “sensism” (see Spence, 2002 ). Sensism provides a key to greater well-being by considering the senses holistically, as well as how they interact, and incorporating that understanding into our everyday lives. The approach also builds on the growing evidence of the nature effect (Williams, 2017 ) and the fact that we appear to benefit from, not to mention actually desire, the kinds of environments in which our species evolved. As support for the latter claim, consider only how it has recently emerged that most people set their central heating to a fairly uniform 17–23 °C, meaning that the average indoor temperature and humidity most closely matches the mild outdoor conditions of west central Kenya or the Ethiopian highlands (i.e., the place where human life is first thought to have evolved), better than anywhere else (Just, Nichols, & Dunn, 2019 ; Whipple, 2019 ).

Architectural design for each of the senses

It is certainly not the case that architects have uniformly ignored the non-visual senses (e.g., see Howes, 2005 , 2014 ; McLuhan, 1961 ; Pallasmaa, 1994 , 2011 ; Ragavendira, 2017 ). For instance, in their 2004 book on Sensory design , Malnar and Vodvarka talk about challenging visual dominance in architectural design practice by giving a more equal weighting to all of the senses (Malnar & Vodvarka, 2004 ; see also Mau, 2019 ). Meanwhile, Howes ( 2014 ) writes of the sensory monotony of the bungalow-filled suburbs and of the corporeal experience of skyscrapers as their presence looms up before those on the sidewalk below. At the same time, however, there is also a sense in which it is the gaze of the inhabitants of those tall buildings who are offered the view that is prioritized over the other senses.

However, very often the approach as, in fact, evidenced by Malnar and Vodvarka ( 2004 ) has been to work one sense at a time. Until recently, that is, one finds exactly the same kind of sense-by-sense (or unisensory) approach in the worlds of interior design (Bailly Dunne & Sears, 1998 ), advertising (Lucas & Britt, 1950 ), marketing (Hultén, Broweus, & Dijk, 2009 ; Krishna, 2013 ; Lindstrom, 2005 ), and atmospherics (see Bille & Sørensen, 2018 , on architectural atmospherics; and Kotler, 1974 , on the theme of store atmospherics). Recently, there has been a growing recognition of the importance of the non-visual senses to various fields of design (Haverkamp, 2014 ; Lupton & Lipps, 2018 ; Malnar & Vodvarka, 2004 ). As yet, however, there has not been sufficient recognition of the extent to which the senses interact. As Williams ( 1980 , p. 5) noted some 40 years ago: “Aside from meeting common standards of performance, architects do little creatively with acoustical, thermal, olfactory, and tactile sensory responses.” As we will see later, it is not clear that much has changed since.

The look of architecture

There are a number of ways in which visual perception science can be linked to architectural design practice. For instance, think only of the tricks played on the eyes by the trapezoidal balconies on the famous The Future apartment building in Manhattan (see Fig.  2 ). They appear to slant downward when viewed from one side while appearing to slope upward instead, if viewed from the other. The causes of such a visual illusion can, at the very least, be meaningfully explained in terms of visual perception research (Bruno & Pavani, 2018 ).

The Future apartment building at 200 East 32nd Street in Manhattan. Architectural design that appeals primarily to the eye? [Credit Jeffrey Zeldman, and reprinted under Creative Commons agreement]

Cognitive neuroscientists have recently demonstrated that we have an innate preference for visual curvature, be it in internal space (Vartanian et al., 2013 ), or for the furniture that is found within that space (Dazkir & Read, 2012 ; see also Lee, 2018 ; Thömmes & Hübner, 2018 ). We typically rate curvilinear forms as being more approachable than rectilinear ones (see Fig.  3 ). Angular forms, especially when pointing downward/toward us, may well be perceived as threatening, and hence are somewhat more likely to trigger an avoidance response (Salgado-Montejo, Salgado, Alvarado, & Spence, 2017 ). As Ingrid Lee, former design director at IDEO New York put it in her book, Joyful: The surprising power of ordinary things to create extraordinary happiness : “Angular objects, even if they’re not directly in your path as you move through your home, have an unconscious effect on your emotions. They may look chic and sophisticated, but they inhibit our playful impulses. Round shapes do just the opposite. A circular or elliptical coffee table changes a living room from a space for sedate, restrained interaction to a lively center for conversation and impromptu games” (Lee, 2018 , p. 142). One might consider here whether Lee’s comments can be scaled up to describe how we move through the city. Does the visually striking building shown in Fig.  4 , for instance, really promote joyfulness and a carefree travel through the urban environment. It seems doubtful, given the evidence suggesting that viewing angular shapes, even briefly, has been shown to trigger a fear response in the amygdala, the part of the brain that is involved in emotion (e.g., LeDoux, 2003 ). Meanwhile, Liu, Bogicevic, and Mattila ( 2018 ) have noted how the round versus angular nature of the servicescape also influences the consumer response in service encounters.

A selection of the interiors shown to participants in a neuroimaging study designed to assess viewers’ approach-avoidance motivation in response to curvilinear vs. rectilinear spaces. [High/Low roof; Open/Enclosed space.] [Figure reprinted with permission from Vartanian et al., 2013 ]

Montcalm Shoreditch Signature Tower Hotel, 151–157 City Road, London, completed 2015 by SMC Alsop Architects. What is lost when architectural design focuses on eye appeal? [Figure copyright Ian Ritchie, RA]

The height of the ceiling has also been shown to exert an influence over our approach-avoidance responses, and perhaps even our style of thinking (Baird, Cassidy, & Kurr, 1978 ; Meyers-Levy & Zhu, 2007 ; Vartanian et al., 2015 ). However, here it should also be born in mind that the visual perception of space is significantly influenced by colour and lighting (Lam, 1992 ; Manav, Kutlu, & Küçükdoğu, 2010 ; Oberfeld, Hecht, & Gamer, 2010 ; von Castell, Hecht, & Oberfeld, 2018 ). Given many such psychological observations, it should perhaps come as no surprise to find that links between cognitive neuroscience and architecture have grown rapidly in recent years (Choo, Nasar, Nikrahei, & Walther, 2017 ; Eberhard, 2007 ; Mallgrave, 2011 ; Robinson & Pallasmaa, 2015 ). At the same time, however, it is also worth remembering that it has primarily been people’s response to examples or styles of architecture that have been presented visually (via a monitor), with the participant lying horizontal, that have been studied to date, given the confines of the brain-scanning environment (though see also Papale, Chiesi, Rampinini, Pietrini, & Ricciardi, 2016 ). Footnote 3

At the same time, however, it is important to realize that it is not just our visual cortex that responds to architecture. For, as Frances Anderton writes in The Architectural Review : “We appreciate a place not just by its impact on our visual cortex but by the way in which it sounds, it feels and smells. Some of these sensual experiences elide, for instance our full understanding of wood is often achieved by a perception of its smell, its texture (which can be appreciated by both looking and feeling) and by the way in which it modulates the acoustics of the space.” (Anderton, 1991 , p. 27). The multisensory appreciation of quality here linking to a growing body of research on multisensory shitsukan perception - shitsukan , the Japanese word for “a sense of material quality” or “material perception” (see Fujisaki, 2020 ; Komatsu & Goda, 2018 ; Spence, 2020b ). The following sub-sections summarize some of the key findings on how the non-visual sensory attributes of the built and urban environment affect us, when considered individually.

The sound of space: are you listening?

What a space sounds like is undoubtedly important (Bavister, Lawrence, & Gage, 2018 ; McLuhan, 1961 ; Porteous & Mastin, 1985 ; Thompson, 1999 ). Sounds can, after all, provide subtle cues as to the identity or proportions of a space, even hinting at its function (Blesser & Salter, 2007 ; Eberhard, 2007 ; Robart & Rosenblum, 2005 ). As Pallasmaa ( 1994 , p. 31) notes: “Every building or space has its characteristic sound of intimacy or monumentality, rejection or invitation, hospitality or hostility.” However, more often than not, discussion around sound and architectural design tends to revolve around how best to avoid, or minimize, unwanted noise (see Owen, 2019 , on growing concerns regarding the latter). Indeed, as J. Douglas Porteous notes: “with the rapid urbanization of the world’s population, far more attention is being given to noise than to environmental sound … Research has concentrated almost entirely upon a single aspect of sound, the concept of noise or ‘unwanted sound.’” (Porteous, 1990 , p. 48). Some years earlier, Schafer ( 1977 , p. 222) had made much the same point when he wrote that: “The modern architect is designing for the deaf …. The study of sound enters modern architecture schools only as sound reduction, isolation and absorption.” The fact that year-on-year, noise continues to be one of the top complaints from restaurant patrons, perhaps tells us all we need to know about how successful designers have been in this regard (see Spence, 2014 , for a review; Wagner, 2018 ).

There is also an emerging story here regarding the deleterious effects of loud background noise, and the often-beneficial effects of music and soundscapes, on the recovery of patients in the hospital/healthcare setting (see Spence & Keller, 2019 , for a review). Meanwhile, one of the main complaints from those office workers forced to move into one of the open plan offices that have become so popular (amongst employers, if not employees) in recent years (see ‘Redesigning the corporate office’, 2019 ) is around noise distraction (Borzykowski, 2017 ; Burkus, 2016 ; Evans & Johnson, 2000 ). Footnote 4 Once again, one might want to ask what responsibility architects bear. Experimental evidence documenting the deleterious effect of open-plan working has been reported by a number of researchers (e.g., Bernstein & Turban, 2018 ; De Croon, Sluiter, Kuijer, & Frings-Dresen, 2005 ; Otterbring, Pareigis, Wästlund, Makrygiannis, & Lindström, 2018 ).

There is research ongoing in a number of countries to investigate the use of nature sounds, such as, for example, the sound of running water, to help mask other people’s distracting conversations (Hongisto, Varjo, Oliva, Haapakangas, & Benway, 2017 ). Intriguingly, however, it turns out that people’s beliefs about the source of masking sounds, especially in the case of ambiguous noise, can sometimes influence how much relief they provide (Haga, Halin, Holmgren, & Sörqvist, 2016 ). So, for instance, Haga and her colleagues played the same ambiguous pink noise with interspersed white noise to three groups of office-workers. To one control group, the experimenters said nothing, a second group of participants was told that they could hear industrial machinery noise, while a third group was told that they were listening to nature sounds, based on a waterfall, instead. Intriguingly, subjective restoration was significantly higher amongst those who thought that they were listening to the nature sounds than in those who thought that they were listening to industrial noise instead. As might have been expected, the results of the control group, fell somewhere in between.

Paley Park in New York has often been put forward as a particularly elegant solution to the problem of negating unwanted traffic noise in the context of urban design (e.g., Carroll, 1967 ; Prochnik, 2009 ). In 1967, the empty lot resulting from the demolition of the Stork Club on 53rd Street was transformed into a small public park (a so-called pocket park). The space was developed by Zion and Breen. In this case, the acoustic space, think only of the sounds, or better said noise, of the city, is effectively masked by the presence of a waterfall at the far end of the lot (see Fig.  5 ). What is more, the free-standing chairs allow the visitor to move closer to the waterfall should they feel the need to drown out a little more of the urban noise. The greenery growing thickly along the side walls also likely helps to absorb the noise of the city.

Paley Park, New York, by Zion and Breen in 1967. [Credit Jim Henderson, and reprinted under Creative Commons agreement]

Music plays an important role in our experience of the built environment - think here only of the Muzak of decades gone by (Lanza, 2004 ). This is as true of the guest’s hotel experience (e.g., when entering the lobby) as it is elsewhere (e.g., in a shopping centre or bar, say). Footnote 5 The sound that greets customers in the lobby is apparently very important to Ian Schrager, the Brooklyn-born entrepreneur who created fabled nightclub Studio 54 in New York. In recent years, he has been working with Marriott to launch The EDITION hotels in a number of major cities, including London and New York. Music plays a key role in the Schrager experience. As the entrepreneur puts it: “The sound of a hotel lobby is often dictated by monotonous, vapid lounge muzak – a zombie-like drone of new jazz and polite house, with the sole purpose of whiling away the waiting time between check-in and check-out.” As might have been expected, the music in the lobbies of The EDITION hotels is carefully curated (Eriksen, 2014 , p. 27). However, the thumping noise of the music from the nightclub/bar that is often also an integral part of the experience offered by these hip venues means that meticulous architectural design is also required in order to limit the spread of unwanted noise through the rest of the building (e.g., so as not to disturb the sleep of those who may be resting in the rooms upstairs). Note here that there are also some increasingly sophisticated solutions - including sound-absorbing panels, as well as active noise cancellation systems - to dampen unwanted sound in open spaces such as restaurants and offices (Clynes, 2012 ).

Designing for “the eyes of the skin”

The tactile element of architecture is often ignored. In fact, very often, the first point of physical contact with a building typically occurs when we enter or leave. Or, as Pallasmaa ( 1994 , p. 33) once evocatively put it: “The door handle is the handshake of the building”. However, once inside a building, it is worth remembering that we will also typically make contact with flooring (Tonetto, Klanovicz, & Spence, 2014 ), hand rails (Spence, 2020d ), elevator buttons, furniture, and the like (though this is, of course, likely to change somewhat in the era of pandemia). As Richard Sennett, author of Flesh and Stone, laments in his critical take on the sensory order of modernity: “sensory deprivation which seems to curse most modern buildings; the dullness, the monotony, and the tactile sterility which afflicts the urban environment” (Sennett, 1994 , p. 15). The absence of tactile interest is also something that Witold Rybczynski author of The Look of Architecture acknowledges when writing that: “Although architecture is often defined in terms of abstractions such as space, light and volume, buildings are above all physical artifacts. The experience of architecture is palpable: the grain of wood, the veined surface of marble, the cold precision of steel, the textured pattern of brick.” (Rybczynski, 2001 , p. 89). Notice here how Rybczynski mentions both texture and temperature, two of the key attributes of tactile sensation(see also Henderson, 1939 ). Temperature change, and change in the flooring material (tatami matting or cedarwood), is also something that the Tom museum for the blind in Tokyo also plays with deliberately (Classen, 1998 , p. 150; Vorreiter, 1989 ; Wagner, 1989 ). There is also a braille poen on the knob of the exit door too.

The careful use of material can evoke tactility as the viewer (or occupant) imagines or mentally simulates what it would feel like to reach out and touch or caress an intriguing surface (Sigsworth, 2019 ; see also Lupton, 2002 ). Juhani Pallasmaa, who has perhaps written more than anyone else on the theme of the tactile, or haptic in architecture, writes that “Natural materials - stone, brick and wood - allow the gaze to penetrate their surfaces and they enable us to become convinced of the veracity of matter … But the materials of today - sheets of glass, enamelled metal and synthetic materials - present their unyielding surfaces to the eye without conveying anything of their material essence or age.” (Pallasmaa, 1994 , p. 29).

Lisa Heschong, architect, and partner of architectural research firm Heschong Mahone Group, has written extensively on the theme of thermal (as opposed to textural) aspects of architectural design in her book Thermal Delight in Architecture (Heschong, 1979 ) . There, she points to examples such as the hearth, the sauna, and Roman and Japanese baths as archetypes of thermal delight about which rituals have developed, the shared experience reinforcing social bonds of affection and ceremony (see also Lupton, 2002 ; Papale et al., 2016 ). At this point, one might also want to mention the much-admired Therme Vals Spa by Peter Zumthor, in Switzerland with their use of different temperatures of both water and touchable surfaces (Ryan, 1997 , though see also Mairs, 2017 ). The tactile element is, in other words, fundamental to the total (multisensory) experience of architectural design. This is true no matter whether the materiality is touched directly or not (i.e., merely seen, inferred, or imagined). So, for example, here one might only think about how looking at a cheap fake marble or wood veneer can make one feel, to realize that touch in often not required to assess material quality, or the lack thereof (see also Karana, 2010 ).

An architecture of the chemical senses

Talking of an architecture of scent, or of taste (these two of the so-called chemical senses), might seem like a step too far. That said, one does come across titles such as Eating Architecture (Horwitz & Singley, 2004 ) and An Architecture of Smell (McCarthy, 1996 ; see also Barbara & Perliss, 2006 ). Footnote 6 Unfortunately, however, all too often, consideration of the olfactory in architectural design practice has focused on the elimination of negative odours. When thinking about the mundane experience of odours in buildings, what immediately comes to mind includes the smell of wood (i.e., building materials), dust, mould, cleaning products, and flowers. As Eberhard ( 2007 , p. 47) puts it: “We all have our favorite smells in a building, as well as ones that are considered noxious. A cedar closet in the bedroom is an easy example of a good smell. The terrible smell of a house that was ravaged by fire or floods is seared in the memory of those who have endured one of these disasters.” This is perhaps no coincidence, given that it tends to be the bad odours, rather than the neutral or positive ones, that have generally proved most effective in immersing us in an experience (Baus & Bouchard, 2017 ; see also Aggleton & Waskett, 1999 ). Research by Schifferstein, Talke, and Oudshoorn ( 2011 ) investigated whether the nightlife experience could be enhanced by the use of pleasant fragrance to mask the stale odour after the indoor smoking ban was introduced a few years ago. Once again, notice how the focus here is on the elimination of the negative stale odours rather than necessarily the introduction of the positive (the latter merely being introduced in order to mask the former).

Jim Drohnik captures the idea of olfactory absence when talking about not just the “white cube” mentality but the “anosmic cube” (Drobnick, 2005 ). The former phrase was famously coined by O’Doherty ( 1999 , 2009 ) in order to describe the then-popular practice of displaying art in gallery spaces that were devoid of colour or any other form of visual distraction. Footnote 7 Some years later, Jim Drobnik introduced the latter phrase in order to highlight the fact that too many spaces are seemingly deliberately designed to have no smell, nor to leave any lasting olfactory trace, either. Footnote 8 And yet, at the same time, it is clear that odour of a space can be incredibly evocative too, as anecdotally noted by Pallasmaa ( 1994 , p. 32) in the following quote: “The strongest memory of a space is often its odor; I cannot remember the appearance of the door to my grandfather’s farm-house from my early childhood, but I do remember the resistance of its weight, the patina of its wood surface scarred by a half century of use, and I recall especially the scent of home that hit my face as an invisible wall behind the door.” And thinking back to my memories of visiting my own grandfather, long since deceased, on his fairground wagon in Bradford, it was undoubtedly the intense smell of “derv” (English slang for diesel-engine road vehicle), the liquid diesel oil that was used for trucks at the time, that I can still remember better than anything else. The residents of buildings tend to adapt to the positive and neutral smells in the buildings we inhabit. This is evidenced by the fact that we are typically only aware of the smell of our own home, what some call building odour, or BO for short, when we return after a long trip away (Dalton & Wysocki, 1996 ; McCooey, 2008 ).

Sick building syndrome and the problem of poor olfactory design

Improving indoor air quality might well also provide an effective means of helping to alleviate some of the symptoms of sick building syndrome (SBS) that were mentioned earlier (Guieysse et al., 2008 ). It is certainly striking how many large outbreaks of this still-mysterious condition reported in the 1980s were linked to the presence of an unfamiliar smell in closed office buildings with little natural ventilation (Wargocki, Wyon, Baik, Clausen, & Fanger, 1999 ; Wargocki, Wyon, Sundell, Clausen, & Fanger, 2000 ). For instance, in June 1986, more that 12% of the workforce of 2500 people working at the Harry S. Truman State Office Building in Missouri came down with the symptoms of SBS over a 3-day period (Donnell Jr. et al., 1989 ). The symptoms presented by some of the workers (including dizziness and difficulty in breathing) were so severe they had to be rushed to the local hospital for emergency treatment. And while a thorough examination of the building subsequently failed to reveal the presence of any particular toxic airborne pollutants that might have been responsible for the outbreak, in the majority of cases, it turned out that the symptoms of SBS were preceded by the perception of unusual odours and inadequate airflow in the building.

According to Donnell Jr. et al. ( 1989 ), these complaints of odours may well have heightened the perception of poor air quality by some employees in the building. This, in turn, may have led to an epidemic anxiety state resulting in the SBS outbreak (Faust & Brilliant, 1981 ). In fact, workers suffering from SBS were more than twice as likely to have noticed a particular odour in the work area before the onset of their symptoms than those who were working in the same building who were unaffected by the outbreak. Footnote 9 At the same time, however, it should also be borne in mind that our tendency to focus on what we see and hear means that we often exhibit olfactory anosmia to ambient scents (Forster & Spence, 2018 ).

To give a sense of the potential scale of the problem, Woods ( 1989 ) estimated that 30–70 million people in the USA alone are exposed to offices that manifest SBS. As such, anything (and everything) that can be done to reduce the symptoms associated with this reaction to the indoor environment (Finnegan, Pickering, & Burge, 1984 ) will likely have a beneficial effect on the health and well-being of many people. At the same time, however, it is perhaps also worth bearing in mind here that the incidence of SBS would seem to have declined in recent years (though see also Joshi, 2008 ; Magnavita, 2015 ; Redlich, Sparer, & Cullen, 1997 ), perhaps suggesting that building design/ventilation has improved as a result of the earlier outbreaks. Footnote 10 That said, it is perhaps also worth noting that there continues to be some uncertainty as to whether the very real symptoms of SBS should be attributed to airborne pollutants, or may instead be better understood as a psychosomatic response to a particular environmental atmosphere (see Fletcher, 2005 and Love, 2018 ). What is more, there has been a move by some researchers to talk in terms of the less pejorative-sounding building-related symptoms (BRS) instead (Niemelä, Seppänen, Korhonen, & Reijula, 2006 ). One more psychological factor that may be relevant here concerns the feeling of a lack of control over one’s multisensory environment that many of those working in ventilated buildings where the windows cannot be opened manually have may indeed play a role in the elicitation of SBS.

Scent and the city: designing fragrant spaces

There are, however, signs that the situation is slowly starting to change with regards to the emphasis placed on olfaction in both architectural and urban design practice. For instance, a number of commentators have noted, not to mention sometimes been puzzled by, the distinctive, yet unexplained, pleasant - and hence, one assumes, deliberately introduced - fragrances that some new constructions appear to have. Just take the case of the Barclays Center arena in Brooklyn, NY, home of the Brooklyn Nets, as a case in point. On its opening in 2013, various commentators in the press drew attention to the distinctive, if not immediately identifiable, scent that appeared to pervade the space, and which appeared to have been added deliberately - almost as if it were intended to be a signature scent for the space (e.g., Albrecht, 2013 ; Doll, 2013 ; Martinez, 2013 ). That said, the idea of fragrancing public spaces dates back at least as far as 1913. In that year, at the opening of the Marmorhaus cinema in Berlin, the fragrance of Marguerite Carré, a perfume by Bourjois, Paris, was deliberately (and innovatively, at least for the time) wafted through the auditorium (Berg-Ganschow & Jacobsen, 1987 ). Meanwhile, in what may well be a sign of things to come, synaesthetic perfumer Dawn Goldsworthy and her scent design company 12:29 recently made the press after apparently creating a bespoke scent for a new US$40 million apartment in Miami (Schroeder, 2018 ). What further opportunities might there be to design distinctive “signature” scents for spaces/buildings, one might ask (Henshaw et al., 2018 ; Jones, 2006 ; Trivedi, 2006 )?

Evidence that the olfactory element of design can be used to affect behaviour change positively includes, for example, the observation that people tend to engage in more cleaning behaviours when there is a hint of citrus in the air (De Lange, Debets, Ruitenburg, & Holland, 2012 ; Holland, Hendriks, & Aarts, 2005 ). In the future, it may not be too much of a stretch to imagine public spaces filled with aromatic flowers and blossoming trees, introduced with the aim of helping to discourage people from littering, and who knows, perhaps even reducing vandalism (see also Steinwald, Harding, & Piacentini, 2014 ). In terms of the cognitive mechanism underlying such crossmodal effects of scent on behaviour, the suggestion, at least in the citrus cleaning example just mentioned, is that smelling an ambient scent that we associate with clean and cleaning then activates, or primes, the associated concepts (Smeets & Dijksterhuis, 2014 ). Having been primed, the suggestion is thus that this makes it that bit more likely that we will engage in behaviours that are congruent or consistent with the primed concept (though see Doyen, Klein, Pichon, & Cleeremans, 2012 ).

Elsewhere, researchers have already demonstrated the beneficial effects that lavender, and other scents normally associated with aromatherapy, have on those who are exposed to them. So, for instance, the latter tend to show reduced stress, better sleep, and even enhanced recovery from illness (see Herz, 2009 ; Spence, 2003 , for reviews; though see also Haehner, Maass, Croy, & Hummel, 2017 ). According to one commentator writing in The New York Times: “While these findings have obvious implications for health care, the opportunities for architecture and urban planning are particularly intriguing. Designers are trained to focus mostly on the visual, but the science of design could significantly expand designers’ sensory palette. Call it medicinal urbanism.” (Hosey, 2013 ). Effects on people’s mood resulting from exposure to ambient scent have been reported in some by no means all studies (Glass & Heuberger, 2016 ; Glass, Lingg, & Heuberger, 2014 ; Haehner et al., 2017 ; Weber & Heuberger, 2008 ). It remains somewhat uncertain though whether the beneficial effects of aromatherapy scents can be explained by priming effects, based on associative learning, as in the case of the clean citrus scents mentioned above (see Herz, 2009 ), versus via a more direct (i.e., less cognitively mediated) physiological route (cf. Harada, Kashiwadani, Kanmura, & Kuwaki, 2018 ).

The olfactory scentscapes, and scent maps of cities, that have been discussed by various researchers (see Fig.  6 ) have also helped to draw people’s attention to the often rich olfactory landscapes offered by many urban spaces (e.g., https://sensorymaps.com/ ; Bucknell, 2018 ; Henshaw, 2014 ; Henshaw et al., 2018 ; Lipps, 2018 ; Lupton & Lipps, 2018 ; Margolies, 2006 ).

Scentscape of the city. Spring scents and smells of the city of Amsterdam by Kate McLean. [Credit “Spring Scents & Smells of the City of Amsterdam” © 2013-2014. Digital print. 2000 x 2000 mm. Courtesy of Kate McLean]

The notion of the healing garden has also seen something of a resurgence in recent years, and the benefits now, as historically, are likely to revolve, at least in part, around the healing, or restorative effect of the smell of flowers and plants (e.g., Pearson, 1991 ; see also Ottoson & Grahn, 2005 ). One building that is often mentioned in this regard, namely in terms of its olfactory design credentials, is the Silicon House by architects, SelgasCano, situated on the outskirts of Madrid ( https://www.architectmagazine.com/project-gallery/silicon-house-6143 ). This house is set in what has been described as “a garden of smells”, which emphasize the olfactory, while also stressing the tactile elements of the design. Hence, while the olfactory aspects of architectural design practice have long been ignored, there are at least signs of a revival of interest in stimulating this sense through both architectural and urban design practice.

Architectural taste

The British writer and artist Adrian Stokes once wrote of the “oral invitation of Veronese marble” (Stokes, 1978 , p. 316). And while I must admit that I have never felt the urge to lick a brick, Pallasmaa ( 1996 , p. 59) vividly recounts the urge that he once experienced to explore/connect with architecture using his tongue. He writes that: “Many years ago when visiting the DL James Residence in Carmel, California, designed by Charles and Henry Greene, I felt compelled to kneel and touch the delicately shining white marble threshold of the front door with my tongue. The sensuous materials and skilfully crafted details of Carlo Scarpa’s architecture as well as the sensuous colours of Luis Barragan’s houses frequently evoke oral experiences. Deliciously coloured surfaces of stucco lustro , a highly polished colour or wood surfaces also present themselves to the appreciation of the tongue.”

Perhaps aware of many readers’ presumed scepticism on the theme of the gustatory contribution to architecture, Footnote 11 Pallasmaa writes elsewhere that: “The suggestions that the sense of taste would have a role in the appreciation of architecture may sound preposterous. However, polished and coloured stone as well as colours in general, and finely crafted wood details, for instance, often evoke an awareness of mouth and taste. Carlo Scarpa’s architectural details frequently evoke sensation of taste.” (Pallasmaa, 2011 , p. 595). The suggestion here that “colours in general … often evoke … [a] taste” seemingly linking to the widespread literature on the crossmodal correspondences that have increasingly been documented between colour and basic tastes (see Spence et al., 2015 , for a review). However, rather than describing this in terms of architecture that one can taste, one might more fruitfully refer to the growing literature on crossmodal correspondences instead (see below for more on this theme).

When, in his book Architecture and the brain , Eberhard ( 2007 , p. 47) talks about what the sense of taste has to do with architecture, he suggests that: “You may not literally taste the materials in a building, but the design of a restaurant can have an impact on your ‘conditioned response’ to the taste of the food.” Environmental multisensory effects on tasting is undoubtedly an area that has grown markedly in interest in recent years (e.g., see Spence, 2020c , for a review). It is though worth noting that just as for the olfactory case, some atmospheric effects on tasting may be more cognitively-mediated (e.g., associated with the priming of notions of luxury/expense, or lack thereof) while others may be more direct, as when changing the colour (see Oberfeld, Hecht, Allendorf, & Wickelmaier, 2009 ; Spence, Velasco, & Knoeferle, 2014 ; Torrico et al., 2020 ) or brightness (Gal et al., 2007 ; Xu & LaBroo, 2014 ) of the ambient lighting changes taste/flavour perception.

“An architecture of the seven senses”?

So far in this section, we have briefly reviewed the unisensory contributions of architectural design organized around each of the five main senses (vision audition, touch, smell, and taste). However, seemingly not content with the traditional five, Pallasmaa ( 1994 ) goes further in the title of one of his early articles entitled “An architecture of the seven senses.” While the text itself is not altogether clear, or explicit, on this point, the skeleton and muscles would appear to be the extra senses that Pallasmaa has in mind here. Indeed, the embodied response of people to architecture is definitely something that has captured the imagination, not to mention intrigued, a number of architectural theorists in recent years (e.g., see Bloomer & Moore, 1977 ; Pallasmaa, 2011 ; Pérez-Gómez, 2016 ).

The vestibular sense is also worthy of mention here (see Gulden & Grüsser, 1998 ; Indovina et al., 2005 ). Anyone who has tried out one of the VR simulations of walking along the outside ledge of a tall building will have had the feeling of vertigo. Normally, architects presumably avoid designing structures that may give rise to such discombobulating feelings. That said, the recent increase in popularity of transparent viewing platforms, and bridges, shows that, on occasion, architects are not beyond emphasizing the important contribution made by this normally “silent” sense. For instance, The Grand Canyon Skywalk is a horseshoe-shaped cantilever bridge with a glass walkway at Eagle Point, Arizona that allows visitors to stand 500–800 ft. (150–240 m) above the canyon floor (Yost, 2007 ). Opened in 2007, by 2015, it had attracted more than a million visitors (see Fig.  7 ). While popular, it is perhaps worth noting that a number of such attractions have recently been closed down in parts of China due to safety fears (Ellis-Petersen, 2019 ). Walking on such structures likely also make people more aware of their own corporeality too, thus engaging the proprioceptive and kinaesthetic senses too. On a more mundane level, Heschong ( 1979 , p. 34) draws attention to the importance of bodily movement in the case of the porch swing whose self-propelled movement, prior to air-conditioning, would have been a thermal necessity in the summer months in the southern states of the USA.

Skywalk from outside ledge. [Attribution: Complexsimplellc at English Wikipedia reprinted under Creative Commons agreement]

Consideration of the putatively embodied response to architecture might lead one back to Hall’s ( 1966 ) seminal early notion of “proxemics”. Hall used the latter term to describe the differing response to stimuli as a function of their distance from the viewer’s body. It is certainly easy to imagine this linking to contemporary notions concerning the different regions of personal space that have been documented around an observer (e.g., Previc, 1998 ; Spence, Lee, & Stoep, 2017 ). However, while these terms might sound more or less synonymous to cognitive neuroscientists, Malnar and Vodvarka ( 2004 ), both licensed architects, choose to take a much more cautious stance concerning these terms, treating them as referencing distinct phenomena in their own book on sensory design.

Interim summary

While the impact of each of the senses, however many there might be, can undoubtedly be analysed in isolation, as has largely been attempted in the preceding sections, the fact of the matter is that they interact one with another in terms of determining our response to the environment, be it built or natural. So, having briefly addressed the contribution of each of the senses to architectural design practice, when studied individually, the next question to consider is how the senses interact in the perception of environment/atmosphere, as they do in many other aspects of our everyday perception. After all, as Malnar notes: “The point of immersing people within an environment is to activate the full range of the senses.” (Malnar, 2017 , p. 146). Pallasmaa ( 2000 , p. 78) makes a similar point writing that: “Every significant experience of architecture is multi-sensory; qualities of matter, space and scale are measured by the eye, ear, nose, skin, tongue, skeleton and muscle.” (cf. Rasmussen, 1993 ).

Malnar and Vodvarka ( 2004 , p. ix) set the scene for the discussion with the opening lines of the preface of their book on sensory design in architecture, where they write: “What if we designed for all our senses? Suppose, for a moment, that sound, touch, and odour were treated as the equals of sight, and that emotion was as important as cognition. What would our built environment be like is sensory response, sentiment, and memory were critical design factors, more vital even than structure and program?” Indeed, those who take up the challenge of designing for the multisensory mind might well take a tip from one commentator, writing in Advertising Age when talking about product innovation who suggested that: “… the most successful new products appeal on both rational and emotional levels to as many senses as possible.” (Neff, 2000 , p. 22). Architectural design practice, I suggest, would be well-advised to strive for much the same in order to optimally stimulate the multisensory mind.

Although not the primary interest of the present review, it is perhaps also worth noting in passing, how a very similar debate on the importance of designing for the non-visual senses has been playing out amongst those interested specifically in landscape design/architecture (Lynch & Hack, 1984 ; Mahvash, 2007 ; Treib, 1995 ). The garden is a multisensory space and as Mark Treib wrote once in an essay entitled “Must landscape mean?”: “Today might be a good time to once more examine the garden in relation to the senses.”

Designing for the multisensory mind: architectural design for all the senses

The architect must act as a composer that orchestrates space into a synchronization for function and beauty through the senses – and how the human body engages space is of prime importance. As the human body moves, sees, smells, touches, hears and even tastes within a space – the architecture comes to life.

The rhythm of an architecture can be felt by occupants as a result of the architect’s composition – or arrangement of all the sensorial qualities of space. By arranging spatial sensorial features, an architect can lead occupants through the functional and aesthetic rhythms of a created place. Architectural building for all the senses can serve to move occupants – elevating their experience. (quote from a blogpost by Lehman, 2009 ).

One of the most exciting developments in cognitive neuroscience in recent decades has been the growing realization that perception/experience is far more multisensory than anyone had realized (e.g., Bruno & Pavani, 2018 ; Calvert et al., 2004 ; Levent & Pascual-Leone, 2014 ; Stein, 2012 ). That is, what we hear and smell, and what we think about the experience, is often influenced by what we see, and vice versa (Calvert et al., 2004 ; Stein, 2012 ). The senses talk to, and hence influence, one another all the time, though we often remain unaware of these cross-sensory interactions and influences. In fact, wherever neuroscientists look in the human brain, activity appears to be modulated by what is going on in more than one sense, leading, increasingly, to talk of the multisensory mind (Ghazanfar & Schroeder, 2006 ; Talsma, 2015 ). The key question here must therefore be what implications this growing realization of the ubiquity of multisensory cross-talk has for the field of architectural design practice?

The problem is that, as yet, there has been relatively little research directed at the question of how atmospheric/environmental multisensory cues actually interact. Mattila and Wirtz ( 2001 , pp. 273–274) drew attention to this lacuna some years ago when writing that: “Past studies have examined the effects of individual pleasant stimuli such as music, color or scent on consumer behavior, but have failed to examine how these stimuli might interact.” At the outset, when starting to consider the multisensory perception of architecture, it is worth noting that it is rarely something that we attend to. Indeed, as Benjamin ( 1968 , p. 239) once noted: “Architecture has always represented the prototype of a work of art the reception of which is consummated in a state of distraction.” To the extent that such a view is correct, one can say that multisensory architecture is rarely foregrounded in our attention/experience. Juhani Pallasma, meanwhile, has suggested that: “An architectural experience silences all external noise; it focuses attention on one’s very existence.” (Pallasmaa, 1994 , p. 31). Once again, the suggestion here would appear to be that attention is directed away from the building and toward the individual and their place in the world. Given that, on an everyday basis, architecture is typically not foregrounded in our attention/experience, one might legitimately wonder as to whether the multisensory integration of atmospheric/environmental cues takes place, given that they are so often unattended.

According to the laboratory research that has been published on this question to date, the evidence would appear to suggest that while the multisensory integration of unattended cues relating to an object or event certainly can occur, it is by no means guaranteed to do so (see Spence & Frings, 2020 , for a review). Perhaps the more fundamental question here, though, is whether we need to attend to ambient/environmental sensory cues for them to influence us. However, the research that has been published to date would appear to suggest that very often environmental cues influence us even when we are not consciously aware of, or thinking about them.

One particularly striking example of this was reported by researchers who manipulated whether French or German music was played in a supermarket (North, et al., 1997 , 1999 ). The results showed that the majority of the wine purchased was French when French music was played, with this reversing to a majority of German wines being sold when German music was played. The even more striking aspect of these results was the fact that the majority of those interviewed after coming away from the tills denied that the background music had any influence over the choices they made. A number of studies have also shown that scents that we are unaware of, either because they are presented just below the perceptual threshold or because we have become functionally anosmic to their constant presence, can nevertheless still influence us (Li, Moallem, Paller, & Gottfried, 2007 ). Similarly, there is also a suggestion that inaudible infrasound waves (i.e., < 20 Hz) may also affect people without their necessarily being aware of their presence (Weichenberger et al., 2017 ). Meanwhile, in terms of visual annoyance, it has been reported that flickering LED lights that look no different to the naked eye can nevertheless trigger a significantly greater number of headaches that non-flickering lights (e.g., see Wilkins, 2017 ; Wilkins, Nimmo-Smith, Slater, & Bedocs, 1989 ). Once again, therefore, this suggests that ambient sensory phenomena do not necessarily need to be perceptible in order to affect us, adversely or otherwise.

On the benefits of multisensory design: bringing it all together

One demonstration of just how dramatic the benefits of designing for multiple senses can be was reported by Kroner, Stark-Martin, and Willemain ( 1992 ) in a technical report. These researchers examined the effects of an office make-over when a company moved to a new office building. The employees in the new office were given individual control of the temperature, lighting, air quality, and acoustic conditions where they were working. Productivity increased by approximately 15% in the new building. When the individual control of the ambient multisensory environment was disabled in the new building, performance fell by around 2% instead. Trying to balance the influence of each of the senses is one of the aims of Finnish architect Juhani Pallasmaa, whose name we have come across at several points already in this text. As Steven Holl notes in the preface to Pallasmaa’s The eyes of the skin : “I have experienced the architecture of Juhani Pallasmaa, … The way spaces feel, the sound and smell of these places, has equal weight to the way things look.” (Pallasmaa, 1996 , p. 7). One example of multisensory architectural design to which Juhani Pallasmaa draws attention in several of his writings is the Ira Keller Fountain, Portland Oregon (see Fig.  8 ).

The Ira Keller Fountain, Portland Oregon. According to Pallasmaa ( 2011 ), p. 596) this is “An architecture for all the senses including the kinaesthetic and olfactory senses.” Once again, the auditory element is provided by the sound of falling water

On the multisensory integration of atmospheric/environmental cues

To date, only a relatively small number of studies have directly studied the influence of combined ambient/atmospheric cues on people’s perception, feelings, and/or behaviour. Mattila and Wirtz ( 2001 ) conducted one of the first sensory marketing studies to be published in this area. These researchers manipulated the olfactory environment (no scent, a low-arousal scent (lavender), or a high-arousal scent (grapefruit)) while simultaneously manipulating the presence of music (no music, low-arousal music, or high-arousal music). When the scent and music were congruent in terms of their arousal potential, the customers rated the store environment more positively, exhibited higher levels of approach and impulse-buying behaviour, and expressed more satisfaction. There is, though, always a very real danger of sensory overload if the combined multisensory input becomes too stimulating (see Malhotra, 1984 ; Simmel, 1995 ).

Meanwhile, in another representative field study, Sayin et al. ( 2015 ) investigated the impact of presenting ambient soundscapes in an underground car park in Paris. In particular, they assessed the effects of introducing western European birdsong or classical instrumental music by Albinoni to the three normally silent stairwells used by members of the general public when exiting the car park. A total of 77 drivers were asked about their feelings on their way out. Birdsong was found to work best in terms of enhancing the perceived safety of the situation - in this case by around 6%. This despite the fact that all of those who were quizzed realized that the sounds that they had heard were coming from loudspeakers. Footnote 12 In an accompanying series of laboratory studies, Sayin et al.’s participants were shown a 60-s first-person perspective video that had been taken in the same Paris car park, or else a short video of someone walking through a metro station in Istanbul. Once again, participants were asked about how safe it felt, about perceived social presence, and about their willingness to purchase a monthly metro pass. Even under these somewhat contrived experimental conditions, the presence of an ambient soundscape once again increased perceived safety as well as the participants’ self-reported intention to purchase a season ticket. It was, though, the sound of people singing Alleluia that proved most effective in terms of enhancing perceived safety amongst those watching the videos. Footnote 13 It is, however, worth bearing in mind here that many of the key results reported in this study were only borderline significant. As such, adequately-powered replication would be a good idea before too much weight is given to these intriguing findings.

Recently, Ba and Kang ( 2019 ) documented crossmodal interactions between ambient sound and smell in a laboratory study that was designed to capture the sensory cues that might be encountered in a typical urban environment. These researchers decided to pair the sounds of birds, conversation, and traffic, with the smells of flowers (lilac, osmanthus), coffee, or bread, at one of three levels (low, medium, or high) in each modality. A complex array of interactions was observed, with increasing stimulus intensity sometimes enhancing the participants’ comfort ratings, while sometimes leading to a negative response instead. While Ba and Kang’s results defy any simple synopsis, given the complex pattern of results reported, their findings nevertheless clearly suggest that sound and scent interact in terms of influencing people’s evaluation of urban design.

The colour of the ambient lighting in an indoor environment has also been shown to influence the perceived ambient temperature and thermal comfort of an environment (e.g., Candas & Dufour, 2005 ; Tsushima, et al., 2020 ; Winzen, Albers, & Marggraf-Micheel, 2014 ). For instance, in one representative study, Winzen and colleagues reported that illuminating a simulated aircraft cabin in warm yellow vs. cool blue-coloured lighting exerted a significant influence over people’s self-reported thermal comfort. The participants rated the environment as feeling significantly warmer under the warm (as compared to the cool) lighting colour. One can only really make sense of such findings from a multisensory perspective (see Spence, 2020a , for a review).

Taken together, then, the results of the representative selection of studies reported in this section demonstrate that our perception of, and/or response to, multisensory environments are undoubtedly influenced by the combined influence of environmental/atmospheric cues in different sensory modalities. So, in contrast to the quote from Mattila and Wirtz ( 2001 ) that we came across a few pages ago, there is now a growing body of empirical research out there demonstrating that atmospheric cues presented in different sensory modalities, such as music, scents, and visual stimuli combine to influence how alerting, or pleasant, a particular environment, or stimulus (such as, for example, a work of art), is rated as being (e.g., Banks, Ng, & Jones-Gotman, 2012 ; Battacharya & Lindsen, 2016 ).

Sensory congruency

In their book, Spaces speak, are you listening ?, Blesser and Salter draw the reader’s attention to the importance of audiovisual congruency in architectural design. They write that: “Aural architecture, with its own beauty, aesthetics, and symbolism, parallels visual architecture. Visual and aural meanings often align and reinforce each other. For example, the visual vastness of a cathedral communicates through the eyes, while its enveloping reverberation communicates through the ears.” (Blesser & Salter, 2007 , p. 3). However, they also draw attention to the incongruency that one experiences sometimes: “Although we expect the visual and aural experience of a space to be mutually supportive, this is not always the case. Consider dining at an expensive restaurant whose decorations evoke a sense of relaxed and pampered elegance, but whose reverberating clatter produces stress, anxiety, isolation, and psychological tension, undermining the possibility of easy social exchange. The visual and aural attributes produce a conflicting response.” (Blesser & Salter, 2007 , p. 3).

Regardless of whether atmospheric/environmental sensory cues are integrated or not, one general principle underpinning our response to multisensory combinations of environmental cues is that those combinations of stimuli that are “congruent” (whatever that term means in this context) will tend to be processed more fluently, and hence be liked more, than those combinations that are deemed incongruent, and hence will often prove more difficult, and effortful, to process (Reber, 2012 ; Reber, Schwarz, & Winkielman, 2004 ; Reber, Winkielman, & Schwartz, 1998 ; Winkielman, Schwarz, Fazendeiro, & Reber, 2003 ; Winkielman, Ziembowicz, & Nowak, 2015 ). Footnote 14 Indeed, it was the putative sensory incongruency between a relaxing slow-tempo music and arousing citrus scent that was put forward as a possible explanation for why Morrin and Chebat ( 2005 ) found that adding scent and sound in the setting of the shopping mall reduced unplanned purchases as compared to either of the unisensory interventions amongst almost 800 shoppers in one North American Mall (see Fig.  9 ).

Morrin and Chebat ( 2005 ). Sales figures (unplanned purchases) in mall as a function of music, scent, or the combination of the two. In this case, multisensory stimulation led to a significant reduction in sales, perhaps because low-tempo music was combined with a likely-alerting citrus scent

Congruency can, of course, be defined at multiple levels. For instance, as we have seen already in this section, sensory cues may be more or less congruent in terms of their arousal/relaxation potential (e.g., Homburg, Imschloss, & Kühnl, 2012 ; Mattila & Wirtz, 2001 ). Mahvash ( 2007 , pp. 56–57) talks about the use of congruent cues to convey the notion of coolness: “… the Persian garden with its patterns of light and shadow, reflecting pools, gurgling fountains, scents of flowers and fruits, and gentle cool breezes 'offers an amazing richness of variety of sensory experiences which all serve to reinforce the pervasive sense of coolness'.” However, different sensory inputs may also be deemed congruent or not in terms of their artistic style (see Hasenfus, Martindale, & Birnbaum, 1983 ; Muecke & Zach, 2007 ; cf. Hersey, 2000 , pp. 37–41). It was stylistic congruency that was manipulated in a couple of experiments, conducted both online and in the laboratory by Siefkes and Arielli ( 2015 ). These researchers had their participants explicitly concentrate on and evaluate the style of the buildings shown in one of two architectural styles (baroque or modern - a short video showing five baroque buildings; there were also a short video, focusing on five modern buildings instead). Their results revealed that the buildings were rated as looking more balanced, more coherent, and to a certain degree, more complete, Footnote 15 when viewed while listening to music that was congruent (e.g., baroque architecture with baroque music - specifically Georg Philipp Telemann’s, Concerto Grosso in D major, TWV 54:D3 (1716)) rather than incongruent (e.g., baroque architecture with Philip Glass track from the soundtrack to the movie Koyaanisqatsi).

Before moving on, though, it is worth noting that in this study, as in many of the other studies reported in this section, there is a possibility that the design of the experiments themselves may have resulted in the participants concerned paying rather more attention to the atmospheric/environmental cues (and possibly also their congruency) than is normally likely to be the case when, as was mentioned earlier, the architecture itself fades into the background. Ecological validity may, in other words, have been compromised to a certain degree.

One of the other examples of incongruency that one often comes across is linked to the growing interest in biophilic design. As Pallasmaa ( 1996 , p. 41) notes: “A walk through a forest is invigorating and healing due to the constant interaction of all sense modalities; Bachelard speaks of ‘the polyphony of the senses’. The eye collaborates with the body and the other senses. One’s sense of reality is strengthened and articulated by this constant interaction. Architecture is essentially an extension of nature into the man-made realm …” Footnote 16 No wonder, then, that many designers have been exploring the benefits of bringing elements of nature into interior spaces in order to boost the occupants’ mood and aid relaxation (Spence, 2021 ). However, one has to ask whether the benefits of adding the sounds of a tropical rainforest to a space such as the shopping area of Glasgow airport, say (Treasure, 2007 ), really outweigh the cognitive dissonance likely elicited by hearing such sounds in such an incongruous setting? Similarly, a jungle soundscape was incorporated into the children’s section of Harrods London Department store a few years ago (Harrods’ Toy Kingdom - The Sound Agency | Sound Branding” https://www.youtube.com/watch?v=EVUUG6VvFKQ ). Nature soundscapes have also been introduced into Audi car salesrooms, not to mention BP petrol station toilet facilities (Bashford, 2010 ; Treasure, 2007 ). It is worth noting here that given the important role that congruency has been shown to play at the level of multisensory object/event perception, there is currently a stark paucity of research that has systematically investigated the relevance/importance of congruency at the level of multisensory ambient, or environmental, cues. As the quotes earlier in this section make clear, it is something to which some architects are undoubtedly sensitive, and on which they already have an opinion. Yet the relevant underpinning research still needs to be conducted.

Ultimately, therefore, while the congruency of atmospheric/environmental cues can be defined in various ways, and while incongruency is normally negatively valenced (because it is hard to process), Footnote 17 issues of (in)congruency may often simply not be an issue for the occupants of specific environments. This may either be because the latter simply do not pay attention to the atmospheric/environmental cues (and hence do not register their incongruency) and/or because they have no reason to believe that the stimuli should be combined in the first place.

Sensory dominance

One common feature of configurations of multisensory stimuli that are in some sense incongruent is sensory dominance. And very often, under laboratory conditions, this tends to be vision that dominates (e.g., Hutmacher, 2019 ; Meijer et al., 2019 ; Posner et al., 1976 ). Under conditions of multisensory conflict, the normally more reliable sense sometimes completely dominates the experience of the other senses, as when wine experts can be tricked into thinking that they are drinking red or rosé wine simply by adding some red food dye to white wine (Wang & Spence, 2019 ). Similarly, people’s assessment of building materials has also been shown to be dominated by the visual rather than by the feel (Wastiels, Schifferstein, Wouters, & Heylighen, 2013 ; see also Karana, 2010 ).

At the same time, however, while we are largely visually dominant, the other senses can also sometimes drive our behaviour. For instance, according to an article that appeared in the Wall Street Journal , many people will apparently refuse to check in to a hotel if there is funny smell in the lobby (Pacelle, 1992 ). Such admittedly anecdotal observations, were they to be backed up by robust empirical data, would then support the notion that olfactory atmospheric cues can, at least under certain conditions, also dominate in terms of determining our approach-avoidance behaviour. Meanwhile, a growing number of diners have also reported how they will sometimes leave a restaurant if the noise is too loud (see Spence, 2014 , for a review; Wagner, 2018 ), resonating with the quote from Blesser and Salter ( 2007 ) that we came across a little earlier.

One other potentially important issue to bear in mind here concerns the “assumption of unity”, or coupling/binding priors that constitute an important factor modulating the extent of crossmodal binding in the case of multisensory object/event perception, according to the literature on the currently popular Bayesian causal inference (see Chen & Spence, 2017 ; Rohe, Ehlis, & Noppeney, 2019 , for reviews). Coupling priors can be thought of as the internalized long-term statistics of the environment (e.g., Girshick, Landy, & Simoncelli, 2011 ). Does it, I wonder, make sense to suggest that we have such priors concerning the unification of environmental/atmospheric cues? Or might it be, perhaps, that in a context in which we are regularly exposed to incongruent environmental/atmospheric multisensory cues - just think of how music is played from loudspeakers without any associated visual referent - that out priors concerning whether to integrate what we see, hear, smell, and feel will necessarily be related, in any meaningful sense, may well be reduced substantially. See Badde, Navarro, and Landy ( 2020 ) and Gau and Noppeney ( 2016 ) on the role of context in the strength of the common-source priors multisensory binding.

Hence, no matter whether one wants to create a tranquil space (Pheasant, Horoshenkov, Watts, & Barret, 2008 ) or one that arouses (Mattila & Wirtz, 2001 ), the senses interact as they do in various other configurations and situations (e.g., Jahncke, Eriksson, & Naula, 2015 ; Jiang, Masullo, & Maffei, 2016 ). There are, in fact, numerous examples where the senses have been shown to interact in the experience and rating of urban environments (e.g., Ba & Kang, 2019 ; Van Renterghem & Botteldooren, 2016 ).

Crossmodal correspondences in architectural design practice

The field of synaesthetic design has grown rapidly in recent years (e.g., Haverkamp, 2014 ; Merter, 2017 ; Spence, 2012b ). According to architectural historian, Alberto Pérez-Gómez, mentioned earlier, the Philips Pavilion designed by Le Corbusier for the 1958 Brussels world’s fair (Fig.  10 ) attempted to deliver a multisensory experience, or atmosphere by means of “forced” synaesthesia (Pérez-Gómez, 2016 , p. 19). Footnote 18 The interior audiovisual environment was mostly designed by Le Corbusier and Iannis Xenakis (see Sterken, 2007 ). From those descriptions that have survived there were many coloured lights and projections and a looping soundscape that was responsive to people’s movement through the space (Lootsma, 1998 ; Muecke & Zach, 2007 ).

Philips pavilion was a World’s Fair pavilion designed for Expo 1958 in Brussels by the office of Le Corbusier. The building, which was commissioned by the electronics manufacturer Philips, was designed to house a multimedia spectacle of sound, light and projections celebrating post-war technological progress. Iannis Xenakis was responsible for much of the project management. [Figure copyright Wikimedia Commons: Wouter Hagens]

True to his oculocentric approach, mentioned at the start of this piece, Le Corbusier apparently concentrated on the visual aspects of the “Poème Electronique”, the multimedia show that was projected inside the pavilion. Meanwhile, his site manager, Iannis Xenakis created “Concret PH” - the soundscape, broadcast over 300 loudspeakers, that accompanied it. It is, though, unclear how much connection there actually was between the auditory and visual components of this multimedia presentation. The notion of parallel, but unconnected, stimulation to eye and ear comes through in Xenakis’ quote that: “we are capable of speaking two languages at the same time. One is addressed to the eyes, the other to the ears.” (Varga, 1996 , p. 114). Moreover, in his later work (e.g., Polytopes), Xenakis pursued the idea of creating a total dissociation between visual and aural perception in large abstract sound and light installations (Sterken, 2007 , p. 33).

At several points throughout his book Pérez-Gómez ( 2016 ), stresses the importance of “synaesthesia” to architecture, without, unfortunately, ever really quite defining what he means by the term. All one finds are quotes such as the following: “primordial synesthetic perception ” , p. 11; “perception is primordially synesthetic”, p. 20; “synaesthesia as the primary modality of human perception”, p. 71. Pérez-Gómez ( 2016 , p. 149) draws heavily on Merleau-Ponty’s ( 1962 , p. 235) Phenomenology of Perception , quoting lines such as: “The senses translate each other without any need of an interpreter, they are mutually comprehensible without the intervention of any idea.” A few pages later he cites Heidegger “truths as correspondence” (Pérez-Gómez, 2016 , p. 162). This does, though, sound more like a description of the ubiquitous crossmodal correspondences (Marks, 1978 ; Spence, 2011 ) than necessarily fitting with contemporary definitions of synaesthesia, though the distinction between the two phenomena admittedly remains fiercely contested (e.g., Deroy & Spence, 2013 ; Sathian & Ramachandran, 2020 ). Abath ( 2017 ) has done a great job of highlighting the confusion linked to Merleau-Ponty’s incoherent use of the term synaesthesia, that has, in turn, gone on to “infect” the writings of other architectural theorists, such as Pérez-Gómez ( 2016 ).

Talking of synaesthetic design may then be something of a misnomer (Spence, 2015 ), the fundamental idea here is to base one’s design decisions on the sometimes surprising connections between the senses that we all share, such as, for example, between high-pitched sounds and small, light, fast-moving objects (e.g., Spence, 2011 , 2012a ). It is important to highlight the fact that while these crossmodal correspondences are often confused with synaesthesia, they actually constitute a superficially similar, but fundamentally quite different empirical phenomenon (see Deroy & Spence, 2013 ).

We have already come across a number of examples of crossmodal correspondences being incorporated, knowingly or otherwise, in design decisions. Just think about the use of temperature-hue correspondences (Tsushima et al., 2020 ; see Spence, 2020a , for a review). The lightness-elevation mapping (crossmodal correspondence) might also prove useful from a design perspective (Sunaga, Park, & Spence, 2016 ). And colour-taste and sound-taste correspondences have already been incorporated into the design of multisensory experiential spaces (e.g., Spence et al., 2014 ; see also Adams & Doucé, 2017 ; Adams & Vanrie, 2018 ). Once one accepts the importance of crossmodal correspondences to environmental design, then this represents an additional level at which sensory atmospheric cues may be judged as congruent (e.g., see Spence et al., 2014 ). One of the important questions that remains for future research, though, is to determine whether there may be a priority of one kind of crossmodal congruency over others when they are manipulated simultaneously.

Conclusions

While it would seem unrealistic that the dominance, or hegemony (Levin, 1993 ), of the visual will be overturned any time soon, that does not mean that we should not do our best to challenge it. As critic David Michael Levin puts it: “I think it is appropriate to challenge the hegemony of vision – the ocular-centrism of our culture. And I think we need to examine very critically the character of vision that predominates today in our world. We urgently need a diagnosis of the psychosocial pathology of everyday seeing – and a critical understanding of ourselves as visionary beings.” (Levin, 1993 , p. 205). While not specifically talking about architecture, what we can all do is to adopt a more multisensory perspective and be more sensitive to the way in which the senses interact, be it in architecture or in any other aspect of our everyday experiences.

By designing experiences that congruently engage more of the senses we may be better able to enhance the quality of life while at the same time also creating more immersive, engaging, and memorable multisensory experiences (Bloomer & Moore, 1977 ; Gallace & Spence, 2014 ; Garg, 2019 ; Spence, 2021 ; Ward, 2014 ). Stein and Meredith ( 1993 , p. xi), two of the foremost multisensory neuroscientists of the last quarter century, summarized this idea when they suggesting in the preface to their influential volume The merging of the senses that: “The integration of inputs from different sensory modalities not only transforms some of their individual characteristics, but does so in ways that can enhance the quality of life. Integrated sensory inputs produce far richer experiences than would be predicted from their simple coexistence or the linear sum of their individual products.”

There is growing interest across many fields of endeavour in design that moves beyond this one dominant, or perhaps even overpowering, sense (Lupton & Lipps, 2018 ). The aim is increasingly to design for experience rather than merely for appearance. At the same time, however, it is also important to note that progress has been slow in translating the insights from the academic field of multisensory research to the world of architectural design practice, as noted by licensed architect Joy Monice Malnar when writing about her disappointment with the entries at the 2015 Chicago Architecture Biennial. There, she writes: “So, where are we? What is the current state of the art? Sadly, the current research on multisensory environments appearing in journals such as The Senses & Society does not appear to be impacting artists and architects participating in the Chicago Biennial. Nor are the discoveries in neuroscience offering new information about how the brain relates to the physical environment.” (Malnar, 2017 , p. 153). Footnote 19 At the same time, however, the adverts for at least one new residential development in Barcelona promising residents the benefits of “Sensory living” ( The New York Times International Edition in 2019, August 31–September 1, p. 13), suggests that at least some architects/designers are starting to realize the benefits of engaging their clients’/customers’ senses. The advert promised that the newly purchased apartment would “provoke their senses”.

Ultimately, it is to be hoped that as the growing awareness of the multisensory nature of human perception continues to spread beyond the academic community, those working in the field of architectural design practice will increasingly start to incorporate the multisensory perspective into their work; and, by so doing, promote the development of buildings and urban spaces that do a better job of promoting our social, cognitive, and emotional well-being.

Availability of data and materials

Not applicable.

It is, though, worth highlighting the fact that the denigration of the sense of smell in humans, something that is, for example, also found in older volumes on advertising (Lucas & Britt, 1950 ), turns out to be based on somewhat questionable foundations. For, as noted by McGann ( 2017 ) in the pages of Science , the downplaying of olfaction can actually be traced back to early French neuroanatomist Paul Broca wanting to make more space in the frontal parts of the brain (i.e., the frontal lobes) for free will in the 1880s. In order to do so, he apparently needed to reduce the size of the olfactory cortex accordingly.

Or, as Tuan ( 1977 , p. 18) once put it: “an object or place achieves concrete reality when our experience of it is total, that is, through all the senses as well as with the active and reflective mind”

Relevant here, Mitchell ( 2005 ) has suggested that there are, in fact, no uniquely visual media.

This an issue close to my own heart currently, as the Department where I work was closed due to the discovery of large amounts of asbestos (see BBC News, 2017 ). The university and the latest firm of architects involved in the project are currently battling it out to determine how much of the new building will be given over to individual offices versus shared open-plan offices and hot-desking. The omens, I have to say (at least pre-pandemic), from what is happening elsewhere in the education sector, do not look good (Kinman & Garfield, 2015 ).

Here, one might also consider the Abercrombie & Fitch clothing brand. For a number of years, the chain also managed to craft a distinctive dance sound to match the dark nightclub-like appearance of their interiors.

Writer Tanizaki ( 2001 ), in his essay on aesthetics In Praise of Shadows , also draws attention to the close interplay that exists, or better said, once existed, between architectural design and food/plateware design in traditional Japanese culture.

Intriguingly, Kirshenblatt-Gimblett ( 1991 , p. 416) describes the white cube as an apparatus for “single-sense epiphanies”.

This despite Baudelaire’s line that the smell of a room is “the soul of the apartment” (quoted in Corbin, 1986 , p. 169).

It is also worth noting how suggestible people can be concerning the presence of an odour, as first demonstrated by Slosson’s ( 1899 ) classic classroom demonstration of students in the lecture theatre detecting a fictitious odour in the air.

It has also been suggested that the energy crisis in the 1970s may also have been partly to blame, as that tended to result in lower ventilation standards.

Indeed, one might wonder whether the latter quote refers more to oral stereoagnosis (Jacobs, Serhal, & van Steenberghe, 1998 ), than specifically to gustation (see also Waterman Jr., 1917 , for the suggestion that the tongue can be more revealing than the hand).

This response is very different from the aesthetic disappointment, or even disgust, felt by the man once hypothetically described by the philosopher Immanuel Kant who was very much enjoying listening to a nightingale’s song until realizing that he was listening to a mechanical imitation instead (Kant, 2000 ).

The owner of the car park did not like the sound of this particular sonic intervention, meaning that the researchers were unable to try it out in the field.

At the same time, however, one might consider how marble, one of the most highly prized building materials is in some sense incongruent, given the rich textured patterning of the veined appearance of the surface is typically perfectly smooth to the touch.

These were the anchors on three of the bipolar semantic differential scales used in this study.

The value of connecting with nature in architectural design practice was stressed by an advertorial for an arctic hideaway that suggests that: “True luxury today is connecting with nature and feeling that your senses work again” as appeared in an article in Blue Wings magazine (December 2019, p. 38).

It should, though, be remembered, that sometimes incongruency may be precisely what is wanted. Just take the following quote regarding the crossmodal contrast of thermal heat combined with visual coolness from Japan as but one example: “In the summer the householder likes to hang a picture of a waterfall, a mountain stream, or similar view in the Tokonama and enjoy in its contemplation a feeling of coolness.” (Tetsuro, 1955 , p. 16).

Though Pérez-Gómez ( 2016 , p. 65) seems to be using a rather unconventional definition of synaesthesia, as a little later in his otherwise excellent work, he defines perceptual synaesthesia as “the integrated sensory modalities”, Pérez-Gómez ( 2016 , p. 65). The majority of cognitive neuroscientists would, I presume, take this as a definition of multisensory perception, rather than synaesthesia. Synaesthesia, note, is typically defined as the automatic elicitation of an idiosyncratic concurrent, not normally experienced, in response to the presence of an inducing stimulus (Grossenbacher & Lovelace, 2001 ).

Eberhard ( 2007 , p. xv) sounds a similarly pessimistic note writing that: “I doubt very much that neuroscientific findings will ever usurp intuition and inspiration as a guiding principle within architecture”.

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Review article, the embodiment of architectural experience: a methodological perspective on neuro-architecture.

• 1 Biological Psychology and Neuroergonomics, Technische Universität Berlin, Berlin, Germany
• 2 Department of Architecture, Design and Media Technology, Aalborg University, Aalborg, Denmark

People spend a large portion of their time inside built environments. Research in neuro-architecture—the neural basis of human perception of and interaction with the surrounding architecture—promises to advance our understanding of the cognitive processes underlying this common human experience and also to inspire evidence-based architectural design principles. This article examines the current state of the field and offers a path for moving closer to fulfilling this promise. The paper is structured in three sections, beginning with an introduction to neuro-architecture, outlining its main objectives and giving an overview of experimental research in the field. Afterward, two methodological limitations attending current brain-imaging architectural research are discussed: the first concerns the limited focus of the research, which is often restricted to the aesthetic dimension of architectural experience; the second concerns practical limitations imposed by the typical experimental tools and methods, which often require participants to remain stationary and prevent naturalistic interaction with architectural surroundings. Next, we propose that the theoretical basis of ecological psychology provides a framework for addressing these limitations and motivates emphasizing the role of embodied exploration in architectural experience, which encompasses but is not limited to aesthetic contemplation. In this section, some basic concepts within ecological psychology and their convergences with architecture are described. Lastly, we introduce Mobile Brain/Body Imaging (MoBI) as one emerging brain imaging approach with the potential to improve the ecological validity of neuro-architecture research. Accordingly, we suggest that combining theoretical and conceptual resources from ecological psychology with state-of-the-art neuroscience methods (Mobile Brain/Body Imaging) is a promising way to bring neuro-architecture closer to accomplishing its scientific and practical goals.

A Brief Introduction: From Pre-Neuro-Architecture to Neuro-Architecture

Before the recent development of neuro-architecture as a research field ( Eberhard and Gage, 2003 ; Eberhard, 2009b ; Ruiz-Arellano, 2015 ), many scholars studied psychological and behavioral effects of architectural experiences in their own way. If we consider architecture as “composed structural space,” three themes that reoccur in the history of architecture practice and theory are those of utilitas, firmitas, et venustas , or utility, strength, and beauty ( Pollio, 1914 ), even if this architectural triad has changed in balance and definition at different points in time. For instance, not only were the Egyptian pyramids a utility and structural achievement, but the spatial design decisions were based on beliefs about the passage from this world to the afterworld and the goal of inducing in visitors experiences related to the afterworld ( Fazio et al., 2008 , p. 27–33). Equally, the Greeks, who were deeply inspired by Egyptian culture ( Rutherford, 2016 ), refined their understanding of buildings expressed in their symmetrical and pillared architecture but continued to reserve special places in the city for buildings that were considered important, such as temples. Important buildings are situated in important places, which remains a common way of building today.

Throughout the history of architecture, from Byzantine, Islamic, Medieval and Romanesque eras to Gothic, Renaissance, and Baroque architecture, the conception of architecture continuously approximated a powerful spiritual status ( Fazio et al., 2008 , p. 1–7). Dominating cities and important religious buildings, including churches, temples, and mosques, were carefully designed according to cultural beliefs. The implicit agreement, throughout history, seems to be that architecture, through its utility, strength, and beauty, affects the human perceiver beyond the ordinary, material world as we know it because it affects the soul and mind ( Stendhal, 2010 ). The relation between divinity and architecture was also expressed by applying the laws of nature in spatial ratios and proportions expressed both through the facades and the plan of buildings [see e.g., Palladio (1965) ]. At any rate, although design decisions about the spatial structures had for a long time been guided by metaphysical views about how the space affects the perceiver, in the nineteenth century this came to change as religion, science and technology became more independent cultural forces.

With technological advancements, such as reinforced concrete, architects began exploring how beauty emerged from the structure and utility of the building itself ( Frascari, 1983 ; Frampton, 1985 ; Corbusier, 2013 ). Open spaces with wide-spanning beams and few structural elements commenced a turn toward the performance of the building. Statements of influential architects point to the importance of functionality for architectural design, such as Louis Sullivan 1 , Mies van der Rohe 2 , or Augustus Pugin 3 . Modern architecture has developed into an interdisciplinary field, taking advantage of the experience of other areas of science, and especially ergonomics has increasingly been reflected in modern architecture ( Charytonowicz, 2000 ).

Modernism made one of its marks through the famous 1910 essay by Loos (2019) in which he describes how ornamentation and art had no function and were thus redundant. In European building culture, it became customary for those influenced by these ideas to see any artistic addition or ornamentation to the interior of spaces or the exterior of buildings as superfluous and to be avoided. Instead, the focus was reoriented toward the building performance, e.g., increased window sizes, bigger open spaces, rethinking city infrastructure according to means of transportation, etc. Architects would optimize the building for its conceptual function and consequently base their design decisions on how well the building would perform. The users of the building, on the other hand, have been reduced to a matter of physical proportions ( Corbusier, 1954 ) associated with a series of assumptions on psychological and behavioral impact.

The pre-neuro-architecture belief that spatial configurations alter psychological and behavioral outcomes is clear throughout history. Designing the world meant to design human lives (including their afterlife according to the ancient Egyptians). Yet, exactly how the designed environment affects our lives remains uncovered and typically inaccessible in the writings of architects and architectural scholars. It is not the question of why we place important buildings in important places in the cities, but why we consider places to be important to begin with. If it is due to its visual exposure from within as well as from exterior vantage points, then we must acknowledge that it is based on the properties of human perception. This is precisely where neuro-architecture comes in.

Neuro-Architecture Definition and Objectives

Neuro-architecture can be seen as an emerging field that combines neuroscience, environmental psychology, and architecture to focus on human brain dynamics resulting from action in and interaction with the built environment ( Karakas and Yildiz, 2020 ). Some scholars also describe neuro-architecture as a field where architects collaborate with neuroscientists to scientifically explore the relationship between individuals and their surrounding environment ( Ezzat Ahmed and Kamel, 2021 ). Regarding the rise of this discipline, the necessity of convergence among architects and neuroscientists was first mentioned in 2003 in an interview with Eberhard and Gage (2003 ; see also Azzazy et al., 2021 ). In that year, the first academic organization focusing on neuro-architecture was formed, the Academy of Neuroscience for Architecture (ANFA; Ruiz-Arellano, 2015 ).

According to Azzazy et al. (2021) , the main objective of neuro-architecture is to study the impact of the architectural environment on the neural system. Based on the understanding of how the brain perceives its surroundings, neuroscience can improve the design process, design strategies, and inform regulations that eventually improve human health and well-being in the future ( Eberhard, 2009b ; Dougherty and Arbib, 2013 ; Azzazy et al., 2021 ). One of the primary foci of this framework is to investigate peoples’ experiences in various contexts, such as the role of office space design in the reduction of stress and increase in productivity, how the design of hospital rooms enhances the recovery of patients, or how the design of churches increases the sense of awe and inspiration.

Overview of Research Paradigms and Methods in Neuro-Architecture

With the continuous development of new brain imaging technologies and new experimental paradigms over the last decades, recent neuro-architectural studies have become increasingly sophisticated. The studies can be roughly divided into two categories that either require participants to remain motionless (stationary paradigms) or that allow physical interaction with the environment (mobile paradigms). Stationary neuroimaging protocols present participants with static visual stimuli of architectural environments while they are sitting in a well-controlled laboratory or while lying in a scanner. Stationary imaging methods like magnetoencephalography (MEG), electroencephalography (EEG), or functional magnetic resonance imaging (fMRI) can reveal the neural basis of statically experiencing the built environment. While the experimental control of stationary architectural studies is often high, the ecological validity is usually low as only two-dimensional snapshots of complex three-dimensional environments are presented that do not allow any kind of interaction with the perceived environment. Mobile protocols, in contrast, allow participants to actively experience real or virtual three-dimensional artifacts with high ecological validity, at the cost of introducing noise to the recordings due to uncontrollable environments and movement-related artifacts in the few select imaging methods that are portable ( Gramann et al., 2021 ). Thus, while stationary protocols allow for experimental control they might not be able to measure the neural aspects of humans perceiving and interacting with the built environment, rendering mobile brain imaging methods an important tool to gain deeper insights into the impact of architecture on the human experience and behavior. Together, results from both stationary and mobile brain imaging approaches can complement each other and contribute to a more comprehensive understanding of the human brain. Several studies using stationary protocols provided first important insights into the relationship of architectural design and human brain responses. These will be introduced in the next section.

Neuro-Architecture Research Methods, Findings and Limitations

Previous studies in neuro-architecture.

Most existing neuro-architectural studies are based on stationary protocols with participants focusing on visual stimuli while being seated or lying down to measure the subjective experience of architectural aesthetics. Investigating event-related potentials (ERP) of the EEG, Oppenheim et al. (2009 , 2010) found that buildings that rank high regarding their social status as they are designed to be more important (like government buildings) or sublime (like religious buildings) have more impact on the perception of sublimity than low-ranking buildings (such as buildings associated with economy or the private life). In these studies, the hippocampus was shown to contribute to the processing of architectural ranking. Other studies discovered that participants perceived curvilinear spaces as more beautiful than rectilinear ones ( Vartanian et al., 2013 ). Using fMRI, the authors explored the neural mechanism behind this phenomenon and found that when participants made approach-avoidance decisions, images of curvilinear architectural interiors activated the lingual and the calcarine gyrus in the visual cortex more than images of rectilinear interiors. When contemplating beauty, curvilinear contours activated the anterior cingulate cortex exclusively ( Vartanian et al., 2013 ). Using the same fMRI dataset, Vartanian et al. (2015) also examined the effects of ceiling height and perceived enclosure on aesthetic judgments in architectural design. They found that rooms with higher ceilings were more likely to be judged as beautiful and activated structures involved in visuospatial exploration and attention in the dorsal stream. Open rooms were judged as more beautiful compared with enclosed rooms and activated regions in the temporal lobes associated with perceived visual motion ( Vartanian et al., 2015 ).

While visual sensory information about architectural features directly impacts architectural experience and the accompanying brain dynamics, higher cognitive processes were also shown to provoke changes in brain activity in the context of architectural experience. For example, expectations about aesthetic value moderated people’s aesthetic judgment. Kirk et al. (2009b) found that if the same image was labeled as being sourced from a gallery rather than being computer generated, its aesthetic ratings were significantly higher. The neural mechanisms involved in this difference in aesthetic ratings were traced to the medial orbitofrontal cortex (OFC) and the prefrontal cortex (PFC; Kirk et al., 2009b ). Memories and experience can also moderate architectural aesthetics judgments. This was shown by Kirk et al. (2009b) who found that architects, compared with non-architects, had increased activity of the bilateral medial OFC and the subcallosal cingulate gyrus, when making aesthetic judgments about buildings, rather than faces. These results show that expertise can modulate the response in reward-related brain areas ( Kirk et al., 2009b ).

While most of the above-described studies focused on the impact of architecture on aesthetic judgments and the accompanying brain dynamics, another line of research focuses on the impact of architectural designs on people’s emotional and affective state. As there are too many studies in this area to report in detail [for an overview see Higuera-Trujillo et al. (2021) ], the following exemplary studies suffice to provide the reader with a broad sense of the research questions and imaging methods used in this field. For example, using EEG in a psychophysics experiment, Naghibi Rad et al. (2019) investigated the impact that window shapes in building facades had on the perceivers’ emotional state and cortical activity. Their behavioral results showed that rectangular, square, circular and semi-circular arches were considered as pleasant window shapes, while windows with triangle and triangular arches were determined as unpleasant. Regarding ERP results, the authors found that the effect of pleasant stimuli was larger in the left hemisphere than that of unpleasant ones ( Naghibi Rad et al., 2019 ), consistent with previous notions of lateralization with regards to emotional processes ( Dimond and Farrington, 1977 ; Reuter-Lorenz and Davidson, 1981 ; Canli et al., 1998 ). By using physiological sensors, such as EEG, Galvanic Skin Response (GSR), and eye-tracking (ET), Shemesh et al. (2021) examined the connection between geometrical aspects of architectural spaces (such as scale, proportion, protrusion, and curvature) and the user’s emotional state in expert and non-expert participants (designers and non-designers, respectively). In general, they found that large symmetrical spaces positively affect users. In addition, the more extreme a change of proportion in height P(H) or width P(W) of virtual spaces was displayed, the stronger the response of distress was observed. All physiological measurements demonstrated significantly increased signals in non-designers than those of designers. This study reflected the connection between manipulations in the geometry of the virtual space and the user’s emotional reaction, especially for non-designers ( Shemesh et al., 2021 ). Analyzing the neural response to restorative environments to investigate stress restoration, Martínez-Soto et al. (2013) found that exposure to restorative environments (like buildings with vegetation-surrounding) led to activation of the middle frontal gyrus, middle and inferior temporal gyrus, insula, inferior parietal lobe, and cuneus. Their findings reflected that endogenous, top-down, directed attention is more active during viewing of low restorative potential vs. high restorative potential environments. This article provided empirical evidence that building-integrated vegetation could be considered for architects in order to improve stress-restoration for residents. As a last example, a study by Fich et al. (2014) found that participants immersed in an enclosed virtual room without windows exhibited greater reactivity to a stress test than those in a virtual room with windows. Physiological reactions of this stress state consisted of both heightened and prolonged spikes in salivary cortisol ( Fich et al., 2014 ). This finding is also consistent with the conclusion of Vartanian et al. (2015) , who found that participants were more likely to judge open rooms as beautiful as compared to enclosed rooms.

Methodological Limitations of Existing Neuro-Architecture Research

A recent literature review in the field of neuro-architecture ( Higuera-Trujillo et al., 2021 ) provided a summary of limitations of current neuro-architectural research. The first limitation, according to the authors, is that the majority of studies are confined to architectural aesthetics, not regarding other aspects of architecture like ergonomics, affordances, or functionality. Accordingly, the authors point out that it is not possible to liken architectural experience to the artistic-aesthetic experience because the latter is only one of the components of the cognitive-emotional dimension of architecture ( Higuera-Trujillo et al., 2021 ). Combining architectural ergonomics with architectural aesthetics facilitates architectural research as it leads to a more comprehensive picture of how architecture is perceived and acted upon. That is, the utility and beauty should be investigated in combination along with the underlying neural mechanism of the user interacting with the environment.

A second limitation according to Higuera-Trujillo et al. (2021) is the low ecological validity of established brain imaging methods that come with significant restrictions regarding the mobility of the participant. Data collection in stationary participants experiencing 2D images of architectural designs come with reduced ecological validity in neuro-architecture research ( Higuera-Trujillo et al., 2021 ). Experimental design and techniques that allow participants to freely explore their built environment will provide an ecological account of the psychological and behavioral phenomena underlying human-architecture interactions.

New Horizons for Architectural Neuroscience

There is a demand for new research approaches to neuro-architecture expanding the horizon for neuroscience and resulting in a wider knowledge base for architecture ( Eberhard, 2009a ). Aligned with Eberhard’s proposition, our contention is that current neuro-architecture methodology should be compatible with ecological psychology (one of many aspects of embodied cognitive sciences) and should make use of mobile brain imaging approaches in order to overcome the above-described limitations.

Architectural experiences are embodied in the sense that people physically interact with architectural spaces while moving through a building, opening doors, or taking the stairs to perceive different perspectives of the built environment through movement ( Pektaş, 2021 ). Therefore, the research object of neuro-architecture itself has inherent embodied features and the appropriate research methodology should also correspond to these embodied properties. In general, the proposed methodology for an ecologically more valid neuro-architecture should be in line with an architectural interaction process which is constituted by closely linked perception and action, and by an indispensable connection of our body, brain, and the environment. Architectural environments provide us with action possibilities ( Jelić et al., 2016 ). The possibilities to act emerge from, and are automatically processed by, our brain-body system during active exploration of our surroundings.

In what follows, we first introduce the theoretical foundation of ecological psychology to then address how ecological psychology theories can be integrated with architectural principles and how the neuro-architectural research questions can be extended from aesthetics to ergonomics within an ecological psychology framework. This offers a solution to existing limitations in current neuro-architectural research. Secondly, we will introduce Mobile Brain/Body Imaging (MoBI; Makeig et al., 2009 ; Gramann et al., 2011 , 2014 ) as one emerging brain imaging approach with the potential to improve the ecological validity of neuro-architecture research. By introducing representative MoBI studies, we will elucidate how the neuro-architectural research’s limitation with regards to brain imaging technique can be overcome.

Extending the Research Question From Aesthetics to Ergonomics Using the Framework of Ecological Psychology

Ecological psychology is an embodied, situated, and non-representationalist approach to cognition pioneered by J. J. Gibson (1904–1979) in the field of perception and by E. J. Gibson (1910–2002) in the field of developmental psychology ( Richardson et al., 2008 ; Lobo et al., 2018 ). Theorizing in psychology has traditionally relied on a number of dichotomies, including those of perception and action, of organism and environment, of subject and object, and of mind and body. The “ecological approach” as articulated by Gibson offers an alternative way of understanding psychological phenomena that challenges these concepts and categories. One illustration of this anti-dualism is evident in the name of the approach. Ecology is the branch of biological science concerned with understanding the relations that biological organisms bear to other organisms and to the environment. The Gibsonian approach is “ecological” because, in contrast with the idea that psychology studies the organism (i.e., its mind and behavior), it instead sees relations between organism and environment as the proper level of analysis: in this view, understanding the organism-environment system as a whole is the starting point for understanding mind and behavior (see e.g., Michaels and Palatinus (2014) ).

Following from this, another dichotomy rejected in the ecological approach is the one between perception and action. As it is usually conceived, perception is an “indirect” process in which meaning is attached to otherwise meaningless or ambiguous sensory information via “detailed internal representations” ( Handford et al., 1997 ; Craig and Watson, 2011 ; Rogers, 2017 ); or as the prominent cognitive scientist David Marr put it, “vision is the process of discovering from images what is present in the world and where it is” ( Marr, 1982 , p. 3). Importantly, in this understanding of perception as a matter of internally reconstructing the external world, perception is also seen as distinct and independent from action: moving around can change the input for perception, but it does not significantly alter the perceptual process itself. Ecological psychology challenges this view by treating perception and action as mutual, reciprocal, continuous and symmetrically constraining processes ( Warren, 2006 ; Richardson et al., 2008 ; Heras-Escribano, 2021 ). In the Gibsonian view, perception isn’t merely associated with action, but it is an action, a process of active exploration of the environment: “perceiving is an act, not a response, an act of attention, not a triggered impression, an achievement, not a reflex” ( Gibson, 1979 , p. 149). As a result, in contrast with the description of the visual system as extracting information about the external world from images, Gibson proposed that the visual system is itself constituted by eyes “set in a head that can turn, attached to a body that can move from place to place” ( Gibson, 1979 , p. 53). And besides being inherently active, perception is also for action—a claim that is central to the Gibsonian theory of affordances.

Affordances

“Affordance” is the term that Gibson (1966; 1977; 1979 ) coined to refer to the possibilities for action that the environment offers to a given organism or agent. For example, a chair affords sitting on, a cup affords grasping with one hand and drinking from, and a table affords supporting the cup. For Gibson, we don’t simply perceive chairs, cups and tables as such (i.e., as mere material objects), but rather we perceive the opportunities for action that those objects make possible for us. It is in this sense that, in the ecological view, perception is for action: perception is of affordances. Importantly, however, affordances are not properties of the objects in and of themselves. The uses and meaning that objects have (i.e., their affordances) are relative to some organism or other. For instance, in the examples just given, the cup only affords grasping and holding for agents that have opposable thumbs (or their functional equivalent); for other organisms, the cup affords different uses, including hiding behind or inside (e.g., for an insect) and a place within which to grow (e.g., for a plant, if the cup is used as a vase). Similarly, the chair affords sitting on, and it also affords stepping on (e.g., to change a lightbulb), but only for people of a certain height: for others (e.g., babies) the chair might afford hiding under or support for standing up, but it might be too tall for other uses.

It is for reasons such as these that affordances have been traditionally understood as relational or agent-relative properties: affordances are “relations between the abilities of organisms and features of the environment” [ Chemero, 2003 , p. 189; see also Chemero (2011) ]. In a landmark study that provided early support for this relational understanding of affordances, Warren (1984) found that the boundary between climbable and unclimbable stairways corresponds to a fixed ratio between riser height and leg length. That is, instead of the stairway having the affordance of “climbability” on its own, the affordance is rather a relational property, and one that participants in Warren’s study were found to be perceptually sensitive to Warren (1984) . This research provided a methodology called intrinsic measurement to quantify affordances, since the unit of climbability is not an extrinsic unit such as centimeters, but the unit intrinsic to the body-environment relation that depends on leg lengths ( Warren, 1984 ). In a follow-up study Warren and Whang (1987) found similar results for the visual guidance of walking through apertures like doorways or other gaps on a wall: consistent with the findings from the study on stairways, an aperture’s passability was found to correspond to an objective body-scale ratio (i.e., a relational property) that is visually perceivable ( Warren and Whang, 1987 ).

Other studies have shown that our perceptual access to such action boundaries fixed at body-scale ratios is not static, but can change over time with changes in body-scale: this varies from the short-term effect that wearing a tall wooden block under one’s shoes has on the perception of opportunities for sitting and stair climbing ( Mark, 1987 ) up to comparatively longer-term effect of bodily changes during pregnancy on (the perception of) the passability of apertures ( Franchak and Adolph, 2014 ). Interestingly, some of these and other studies have found that participants were wildly inaccurate when asked to estimate absolute properties (such as heights and widths in centimeters or inches), which suggests that the perception of affordances (i.e., agent-relative properties) is more fundamental than, and independent from, the perception of non-agent-relative properties.

As these examples illustrate, the concept of affordance undermines the dichotomy of perception and action because, in this view, perception is the active exploration of opportunities for action in the environment (i.e., affordances). Moreover, the ecological theory of affordance perception also illustrates the rejection of the dichotomies between organism and environment, subject and object: as relational properties, affordances are features of an organism-environment system as a whole rather than characteristics of the environment and environmental objects on their own. And insofar as affordances constitute the action possibilities that an object or the environment offers some agent, the ecological approach also challenges traditional separations between mind and body. In this view the functional “meaning” of an object does not belong to an immaterial mental dimension separate from the material dimension of the body, as if the mind has to interpret sensory stimulation in order to infer what might be possible to do: rather, affordances are the action opportunities that objects have for some agent (and that the agent can directly perceive) precisely because of the agent’s particular physical structure and bodily activity.

Through embodied experience in architectural spaces we thus encounter possibilities for action that are linked to affective, cognitive, and physiological responses. In this sense, architecture shapes the way we perceive the environment. This should change the view on how architecture influences brain dynamics. Moreover, Warren’s (1984) research can be considered as an exemplary case to combine affordances with ergonomics in an architectural environment. The intrinsic measurement of this study demonstrates that research questions on ergonomic dimensions in architecture can be raised at the ecological scale allowing for a better understanding of the user’s interaction with the architectural environment in terms of complementarity between subjective capacities and objective properties. For instance, inspired by the above studies ( Warren, 1984 ; Mark, 1987 ; Warren and Whang, 1987 ; Franchak and Adolph, 2014 ), in neuro-architectural research the operationalization of experimental variables with regards to architectural affordances should take into account both environmental properties (such as the height of stairs, the size of the apertures, etc.) and participants’ physical capabilities (such as the height of legs, the width changes of the body during pregnancy, etc.). It is promising to investigate this complementarity between architectural properties and the users’ embodied abilities at the ecological scale and also its underlying brain dynamics. In addition, it demonstrates the potential of neuro-architectural research questions to be extended from aesthetics to ergonomics within an ecological psychology framework.

Active Exploration

As just seen, according to ecological psychology agents perceive affordances in a direct process of embodied activity: it is through the agents’ active exploration of the environment ( Michaels and Carello, 1981 ; Heft, 1989 ; Rietveld and Kiverstein, 2014 ) that affordances are perceived, rendering the embodied experience of the built environment a perception-action loop. While in the last section we described how affordances impact active exploration, we now turn to the impact of active exploration on affordances.

Architectural affordances are perceived directly when we move through the built environment. When the observer remains stationary, or when architecture is presented as an image, architectural affordances will be limited to this one specific perspective ( Heft, 2010 ). As stated by Heras-Escribano (2019) , all organisms perceive affordances directly on the condition of unrestricted exploration and sufficient ecological information in their environment. The significance of active exploration is not only reflected in the process to discover new affordances, but also in the process of modifying existing perceptual information. The popular optical illusion of the Ames room (see Figure 1 ; Ittelson, 1952 ) was discussed by Gibson to demonstrate that the illusion could be reduced through unrestricted exploration ( Gibson, 1979 ). Under a single and stationary point of observation of the Ames Room, the eye of the observer is fooled. When an observer views the Ames Room from various angles with binocular information, however, it is easy to notice the sharp sloped floor of the room. Normally, the ceiling and floor are parallel and walls are at a right angle to the ground; but when looking into the Ames Room, the observer can only assume that the room is geometric if active exploration is restricted. Once the observer discovers the abnormal conditions of the Ames room through active exploration, the observer will immediately reject their earlier assumption and also the existing illusory impression ( Gibson, 1979 ). In short, the exploratory activity is crucial for both picking up new affordances and modifying existing ones. Therefore, active exploration is the core ecological approach for investigating an agents’ perception of architectural affordances.

Figure 1. A sketch of the Ames Room. (A) Displays what the perceiver encounters from a given point. Color-codes are used throughout the diagrams. (B) Displays a conceptual plan-drawing of an Ames Room. The red dashed lines represent the field of view of the perceiver. (C) Reveals the actual conditions under which an Ames room functions. The red dashed lines represent the field of view of the perceiver, while the blue dashed lines represent the outline of a rectangle, which the Ames room illusion suggests to exist from a specific angle (A) .

The Convergence of “Exploration” and “Affordance” With Architectural Design

Ecological psychology provides us with a relational perspective to account for perception and action: perception is for action, and action is for perception. This perception-action loop is neither understood as an organism-only nor an environment-only scale, but as co-depending between organism and environment. As affordances of most environments have been designed either by ourselves (e.g., our private spaces) or by architects (e.g., public spaces), we briefly investigate how architectural affordances relate to active exploration. Providing examples of ergonomic dimensions of architectural experience, the following illustrations demonstrate the convergence of “exploration” and “affordance” with architectural design.

Affordances and active exploration are not only theoretical tenets of ecological psychology, but a practical requirement of architecture: after all, every built environment, whether natural or virtual, has affordances. Instead, we focus on features of architecture that have an inviting affordance that appeals to the physical structure of the organism and its immediate relation. Carlo Scarpa, an Italian architect, was famously known for his capacity to address the rhythm of the body by creating details that invited certain movements in a specific order. Giardino Querini Stampalia (1961–1963) uses strategic changes in the pavement from grass, to small cobblestones and concrete, to intentionally alter the velocity of the walking, moreover all stairs in the garden have each a step for either the right or the left foot [see e.g., Dodds (2000) ]. This eventually also causes different heights between steps which now also invites sitting. The rhythm and affordances of walking have then been designed by confining the actively exploring body in this case to both the velocity of the walkability and the specific order of movement for the climbability of the stairs. The very same applies to the staircase of Scarpa’s Olivetti Showroom (1958). As some of the steps are stretched so they float mid-air, they afford being used as a table or a place to sit ( Carter, 2018 ).

As a second contemporary example, consider the work of RAAAF who explicitly attempts to design the affordances of the environment to make the spaces more suitable for the designed function. Consisting of the ecological psychologist and philosopher Erik Rietveld and the architect Ronald Rietveld, the duo has produced numerous projects that demonstrate how architectural affordances can inherently be used to alter the behavior of users. For instance, the project The End of Sitting (2014) radically challenged the mainstream structure of office landscapes by altering the affordances of “working at a desk” ( Rietveld, 2016 ). Instead, RAAAF designed a physical landscape that invites various body postures suitable while working, e.g., laying, leaning, semi-crouching, and so on. Through active exploration, the users would realize that each part of the landscape provided its unique affordances. These examples all share inviting/suggestive designs that couple the agent with the environment in ways that alter neurobehavioral states.

These are only two of many cases in architecture in which a design principle with regards to active exploration and affordances were applied. We believe that since active exploration and affordances constitute our perception of the environment, including architectural design, any serious investigation of the experience of architecture must provide an active interaction with the environment under investigation. This view raises an important challenge for the field of neuro-architecture: studying the cognitive and neural basis of the effect of architectural features requires an interactive neuroimaging approach. In the next section, we demonstrate one way of overcoming this challenge.

Mobile Brain/Body Imaging as a Practical Basis for Architectural Neuroscience

Mobile Brain/Body Imaging is an emerging brain/body imaging method which allows for investigating the exploratory proposition of ecological psychology with the potential to improve the ecological validity of empirical research ( Parada and Rossi, 2021 ). Several studies in the last few years demonstrated that MoBI can be used to specifically improve the ecological validity in neuro-architectural studies by allowing for active exploration of the built environment ( Banaei et al., 2017 ; Djebbara et al., 2019 , 2021 ). In this section, we will describe how MoBI can improve the ecological validity of research within the field of neuro-architecture providing a brief introduction to the methods and a review of representative studies in the field of neuro-architecture.

Mobile Brain/Body Imaging: Definition, Main Goals and Instruments

Mobile Brain/Body Imaging is defined as a multimethod approach to imaging brain dynamics in humans actively moving through and interacting with the environment ( Jungnickel et al., 2019 ). It requires adequate hardware and software solutions to simultaneously record data streams from brain dynamics, motor behavior, and environmental events, and it requires data-driven analyses methods for multi-modal data to dissociate the brain from non-brain processes ( Makeig et al., 2009 ; Gramann et al., 2011 ). The main goal of MoBI is to model and understand natural cognition during unrestricted exploratory action in the immediate environment ( Gramann et al., 2014 ; Parada, 2018 ; Parada and Rossi, 2021 ).

Mobile Imaging means that participants should be allowed to actively explore the environment in order to reflect the neural dynamics underlying embodied cognitive processes. This necessitates small and lightweight measurement instruments. Brain/Body Imaging refers to the investigation of the neural mechanisms of cognitive processes that make use of our physical structure for cognitive goals, and the connection of mind and behavior, perception and action, and sensorimotor coupling on the ecological scale. Both brain and behavioral dynamics have to be recorded in synchrony to explore the bidirectional influence between behavior and brain dynamics. Capturing brain/body dynamics will require multiple sensors to record the different data streams and software to integrate them synchronously (see Figure 2 ).

Figure 2. The illustration depicts a MoBI setup using mobile EEG hardware combined with virtual reality and motion capture through the VR tracking system [from Djebbara et al. (2021) ; used with permission].

Studies in the real world, while providing high ecological validity, do miss control of unwanted factors and cannot simply repeat stimuli material to gain a better signal-to-noise ratio in the signal of interest. Thus, for controlled and repeated stimulus presentation, head-mounted virtual reality (VR) or augmented reality (AR) displays can be integrated in the MoBI hardware system providing an alternative for presenting participants with different environments that can be actively explored while allowing for experimental control and systematically manipulating experimental variables of interest. Furthermore, other stimulus modalities, such as auditory and tactile stimuli, could also be compatible with head-mounted VR displays ( Jungnickel et al., 2019 ).

Previous Mobile Brain/Body Imaging Studies in Neuro-Architecture

Using MoBI, Banaei et al. (2017) investigated human brain dynamics related to the affective impact of interior forms when the perceiver actively explores an architectural space. The experimental task required participants to naturally walk through different architectural spaces with interior forms extracted from a large corpus of architectural pictures. The rooms represented different combinations of interior forms derived from formal cluster analysis of pictures of the real built environment. Importantly, in order to investigate human brain dynamics related to the affective experience of interior forms during architectural exploration, multimodal data were recorded including EEG and motion capture ( Banaei et al., 2017 ).

The authors found that curvature geometries of interior forms influenced brain activity originating from the anterior cingulate cortex (ACC) while the posterior cingulate cortex and the occipital lobe were involved in the processing of different room perspectives ( Banaei et al., 2017 ). This MoBI architectural neuroscience study demonstrates that both the architectural interior form (such as type, location, scale, and angle) and the exploration of the surroundings will shape the experience of the built environment, providing a neuroscientific basis for architectural design ( Banaei et al., 2017 ). Additionally, this research illustrates the potential of MoBI to investigate human brain dynamics and natural experience of participants actively exploring architectural environments.

Another MoBI study by Djebbara et al. (2019 , 2021) investigated the human brain dynamics during transitions through doors of different widths. The authors aimed to investigate how architectural affordances affect brain dynamics by creating three kinds of transitions differing in their passability. Of the three doors, only one did not afford to be transitioned. In the experimental task, implemented in VR, the participants moved from one room to a second room, passing one of the three doors connecting the rooms. The door width which could either be impassable (narrow), passable (medium), or easily passable (wide) formed the operational definition of architectural affordance in their experiment. For priming different interactions with this environment, the authors used a Go/NoGo paradigm either prompting the person to pass through the door (the Go condition), or indicating that the person should not pass through the door (NoGo condition). EEG was used to record their brain activity during the task and a Self-Assessment Manikin (SAM) questionnaire was used to measure participants’ emotional experience after every trial ( Djebbara et al., 2019 , 2021 ).

The subjective reports from the SAM showed that different transition affordances influenced the architectural experience of participants. Different door widths influenced participants’ emotional experience, especially when instructed to pass through the door (i.e., forced interaction with the environment) as compared to instructions that did not require interactions with the environment. The physiological results, on the other hand, revealed that brain activity in visual sensory regions and motor areas reflected the affordance of the transition already around 200 ms, irrespective of whether participants knew that they should or should not pass into the second room. This reflects an automated processing of the affordance present in the built environment even if no further interaction with the environment is planned. In addition, differences in the post-imperative negative variation (PINV), a component of the event-related potential (ERP) of the EEG, were visible only in trials that required an interaction with the environment (Go-trials) while in the NoGo condition, this architectural affordance effect was not observed. In other words, the possible interactions with the transition automatically activated cortical areas underlying perceptual and motor responses even in the absence of planned interactions while additional affordance-specific modulations of brain activity were observed during interactions with the built environment ( Djebbara et al., 2019 , 2021 ).

The results from Djebbara et al. (2019) support the view that possibilities of imminent actions shape our perception ( Djebbara and Gramann, 2022 ). This view is consistent with the propositions of direct perception and perception-action coupling within ecological psychology ( Djebbara et al., 2019 ; Gepshtein and Snider, 2019 ). The reasons why imminent action possibilities will influence our architectural perception are that the information is exactly embedded inside imminent action and will further emerge and be perceived during the exploration process rather than a signal transformation, representation, and computation process. Much like Warren’s (1984) research helped elucidate the behavioral dimension of architectural experience, the study of Djebbara et al. (2019) is an exemplary case of integrating the theoretical framework of ecological psychology with neuro-architecture.

In short, MoBI makes it possible to discover, quantify and visualize the embodiment of human agents in an architectural environment with all relevant dimensions of architecture such as aesthetics, ergonomics and more, which can’t be realized by a stationary experimental paradigm. MoBI is an efficient technique to study natural cognition in architectural exploration. However, as the interaction with the environment can become relatively complex in terms of sensory information and motor behavior, a cautious and systematic approach is advisable. As suggested by Parada (2018) and King and Parada (2021) , the careful and incremental approach to introducing more complex environments and motor behavior, going from highly controlled setups to more ecologically valid ones, ensures the replicability and control over variables. In other words, by first identifying what to look for, e.g., cortical or behavioral features, in a highly controlled experiment, it is then possible to introduce incremental complexity and assess the quality of the more ecologically valid experiments.

Although neuro-architecture is a thriving field, there are two methodological limitations within neuro-architectural research ( Higuera-Trujillo et al., 2021 ). The existing research in the field of architectural neuroscience mainly addresses aesthetics out of many different relevant architectural aspects. The brain imaging methods that are typically used require participants to remain stationary, which prevents natural interactions with their architectural surroundings.

In the present article, we argued that concepts of ecological psychology like affordance and active exploration could extend the horizon of the research questions within neuro-architecture to include ergonomics in architecture, which widens the theoretical and empirical framework under which neuro-architectural research is conducted leading to a more comprehensive picture. That is, both the utility and beauty in architecture should be investigated including the analyses of the underlying neural mechanism. Accordingly, inspired by several empirical studies, the operational definition of variables with regards to architectural ergonomics could be established from the perspectives of the complementarity between environmental properties and the agent’s physical capacities, as well as the perception-action loop during architectural exploration. This, however, requires new technological solutions to imaging human brain dynamics during active exploration and interaction with the built environment.

Emerging brain imaging techniques like MoBI, implementing the exploration proposition of ecological psychology in experimental protocols, overcome the limitations of prevalent stationary brain imaging methods and improve the ecological validity of empirical neuroscientific research. Based on the potential of MoBI, more ecologically valid experimental research within the field of neuro-architecture can be conducted. Existing MoBI studies already show evidence of how the brain perceives its surroundings. These new insights can be used to improve architectural design strategies and regulations to eventually improve human health and well-being.

In summary, we described an integrative methodological framework to combine ecological psychology with state-of-the-art neuroscience methods for neuro-architectural empirical research, aiming at extending the horizon of the research questions in the field of neuro-architecture and improving the ecological validity of its experimental framework. This is a promising way to push the field of neuro-architecture forward.

Author Contributions

All authors listed have made a substantial, direct, and intellectual contribution to the work, and approved it for publication.

We acknowledge support by the German Research Foundation and Open Access Publication Fund of TU Berlin. SW was funded by a grant from China Scholarship Council (File No. 201906750020).

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Acknowledgments

The authors would like to thank Bilal Arafaat for fruitful discussions and proofreading of the manuscript.

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Keywords : neuro-architecture, ecological psychology, mobile brain/body imaging (MoBI), methodology, aesthetics and ergonomics, ecological validity

Citation: Wang S, Sanches de Oliveira G, Djebbara Z and Gramann K (2022) The Embodiment of Architectural Experience: A Methodological Perspective on Neuro-Architecture. Front. Hum. Neurosci. 16:833528. doi: 10.3389/fnhum.2022.833528

Received: 11 December 2021; Accepted: 30 March 2022; Published: 09 May 2022.

Reviewed by:

Copyright © 2022 Wang, Sanches de Oliveira, Djebbara and Gramann. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Sheng Wang, [email protected]

Yakun Sophia Shao

Assistant professor, sk hynix faculty fellow, eecs, uc berkeley, ysshao [at] berkeley [.] edu, cory 570, berkeley, ca 94720, [cv] [google scholar].

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• Published: 30 May 2024

Challenges and advantages of electronic prescribing system: a survey study and thematic analysis

• Hamid Bouraghi 1 ,
• Behzad Imani 2 ,
• Abolfazl Saeedi 3 ,
• Ali Mohammadpour 1 ,
• Soheila Saeedi 1   na1 ,
• Taleb Khodaveisi 1   na1 &
• Tooba Mehrabi 4  

BMC Health Services Research volume  24 , Article number:  689 ( 2024 ) Cite this article

Metrics details

Introduction

Electronic prescribing (e-prescribing) systems can bring many advantages and challenges. This system has been launched in Iran for more than two years. This study aimed to investigate the challenges and advantages of the e-prescribing system from the point of view of physicians.

In this survey study and thematic analysis, which was conducted in 2023, a researcher-made questionnaire was created based on the literature review and opinions of the research team members and provided to the physician. Quantitative data were analyzed using SPSS software, and qualitative data were analyzed using ATLAS.ti software. Rank and point biserial, Kendall’s tau b, and Phi were used to investigate the correlation between variables.

Eighty-four physicians participated in this study, and 71.4% preferred to use paper-based prescribing. According to the results, 53.6%, 38.1%, and 8.3% of physicians had low, medium, and high overall satisfaction with this system, respectively. There was a statistically significant correlation between the sex and overall satisfaction with the e-prescribing system ( p -value = 0.009) and the computer skill level and the prescribing methods ( P -value = 0.042). Physicians face many challenges with this system, which can be divided into five main categories: technical, patient-related, healthcare providers-related, human resources, and architectural and design issues. Also, the main advantages of the e-prescribing system were process improvement, economic efficiency, and enhanced prescribing accuracy.

The custodian and service provider organizations should upgrade the necessary information technology infrastructures, including hardware, software, and network infrastructures. Furthermore, it would be beneficial to incorporate the perspectives of end users in the system design process.

Peer Review reports

Medicine, a crucial commodity in healthcare due to its economic and strategic value, is a fundamental pillar in primary disease treatment. It constitutes significant health expenditures and budgets worldwide [ 1 ]. The prudent management of this valuable resource, through its appropriate prescription and usage, is essential. This is a key factor in ensuring the health security of communities [ 2 ]. Numerous studies indicate that errors in drug administration are prevalent. Although a significant proportion of these errors are preventable, they can leave serious complications for patients and even fatalities [ 3 ]. As the complexity of the drug prescribing process increases, resultant injuries and complications will likely escalate. Therefore, medication prescription is one of the main concerns and priorities of policymakers and trustees in the healthcare domain. In this regard, relentless endeavors are undertaken to enhance and optimize this process, and new supplementary solutions will be used as required. Employing electronic prescription (e-prescribing) systems as an alternative to manual prescription is a practical solution that can enhance and streamline this critical process [ 4 ].

In the traditional paper-based prescribing system, numerous issues arise, including illegible prescriptions, ambiguous orders, omissions, prescription forgery, and misidentification of patients. Studies indicate that these problems compromise patient safety and negatively impact the outcomes of drug treatments [ 5 , 6 ]. E-prescribing emerges as an effective and definitive solution to the inefficiencies, susceptibility to fraud, and administrative burdens associated with paper-based prescribing systems [ 7 ]. E-prescribing extends beyond merely utilizing a computer for prescription writing and storage. This technology encompasses all stages of the prescription process, including patient identification, prescription registration, prescription modification, duplication and renewal of prescriptions, and the transfer of prescriptions among stakeholders, all facilitated through specialized software and internet platforms [ 8 , 9 , 10 ].

As an information system, the e-prescribing system can integrate with other organizational systems, such as electronic health records and pharmacy information systems, within healthcare centers like hospitals [ 11 ]. Through the implementation and utilization of such a system, it is possible to overcome the problems and constraints of the traditional prescribing system due to the complexity of medical care and the increase in the number of drugs, thereby benefiting from its potential advantages. Some of the benefits of an e-prescribing system include reducing healthcare costs for stakeholders (patients, healthcare providers, insurers, and policymakers), reducing common prescribing errors, improving medication outcomes, increasing patient safety, increasing the readability and accuracy of prescriptions, enhancing coordination among stakeholders involved in the drug therapy process, and supporting clinical decision-making at the time of drug administration [ 12 , 13 , 14 ].

Despite the potential benefits of e-prescribing systems in the healthcare industry and significant investments and efforts by stakeholders to support such systems, their usage and adoption remain low, resulting in the failure of numerous implemented projects [ 11 , 12 ]. Given that e-prescribing systems are designed according to the specific needs and internal standards of each country, numerous studies have been conducted worldwide to investigate the benefits, challenges, the reasons for the failure and lack of acceptance of such systems [ 15 , 16 ].

E-prescribing systems in countries like Denmark, the United States, Finland, Sweden, and the United Kingdom are commonly tested and implemented at state, local, or regional levels. These systems cover the entire or a significant portion of the prescribing process. Variations in healthcare and insurance systems across different countries lead to diverse approaches regarding e-prescribing and its evolution. Consequently, these countries exhibit distinct starting points, implementation procedures, and technical strategies. Moreover, e-prescribing systems and models vary not only across different countries but also within the same country [ 17 ]. While meticulously developed and successfully implemented in the United States of America, England, and Germany, this system has reached significant maturity and yielded substantial advantages for the health systems of these countries. However, in other nations, especially developing countries, e-prescribing still encounters significant challenges on its path to widespread acceptance and goal achievement [ 18 , 19 , 20 , 21 ].

Recognizing that the implementation of e-prescribing is a priority for the Iran Ministry of Health and Medical Education (MOH), the Iran Food and Drug Administration (IFDA) established a multi-stakeholder working group in 2015. This group, composed of medical informatics experts, aimed to develop recommendations for effective e-prescribing implementation [ 22 ]. In Iran, adopting e-prescribing in governmental and university hospitals has been proposed as a legal requirement since 2020. The Social Security Organization, a pioneering institution in this domain, has aligned with the implementation policies of this plan and has ceased issuing treatment booklets since early 2021 [ 23 ]. The Health Insurance Organization, as another government institution, independently developed and deployed its e-prescription system across all medical education centers affiliated with universities of medical sciences in Iran. Consequently, the two primary organizations (Social Security Organization and Health Insurance Organization) have successfully implemented the e-prescribing system. Their goals include efficient management of healthcare resources, reduction of common manual prescribing errors, and enhancement of patient safety [ 24 ].

In general, medical centers in Iran employ three distinct electronic prescription systems. “Electronic Prescription (EP)” and “Dinad” serve outpatients covered by the Social Security and Health Insurance Organization, while “Shafa” caters to all inpatients. For individuals without coverage from these insurances, physicians resort to paper prescriptions [ 25 ]. Electronic prescribing was not implemented simultaneously in all provinces of Iran. It was first used on a trial basis in a few provinces and then implemented throughout the country. Although these systems have provided significant benefits to their users in Iran, they have also encountered numerous challenges. Consequently, this comprehensive study was undertaken to explore both the advantages and obstacles associated with e-prescribing systems in Iran.

This survey study and thematic analysis was conducted to examine the challenges and advantages of the e-prescribing system in Iran in 2023. This study was conducted in three main steps: literature review and questionnaire design, data collection, and data analysis.

Literature review and questionnaire design

In the first step of this research, a questionnaire was designed based on the review of similar studies and the opinions of the research team members. To design the questionnaire, various databases, including PubMed, Google Scholar, and Scopus, were searched with related terms such as “electronic prescribing,” “electronic prescribing challenges,” and “electronic prescribing advantages.” Then, the most relevant articles retrieved from these databases were examined, and relevant data were extracted from these articles. Then, focus group sessions were held with the research team. The data extracted from the articles were presented in the sessions, and based on these data and the opinions of the research team, the questionnaire was finalized. This questionnaire had three sections: (1) demographic data (2), questions related to the advantages and challenges of e-prescribing, and (3) open-ended questions related to the challenges and advantages of the e-prescribing system. A five-point Likert scale from completely agree to completely disagree was used for the questions of the second part of the questionnaire. The face and content validity of the questionnaire was checked and confirmed with the cooperation of five experts in health information management, medical informatics, and information technology who were thoroughly familiar with prescribing systems. The content validity of the questionnaire was measured using the Content Validity Index (CVI) and Content Validity Ratio (CVR). To determine CVR, the experts were asked to classify each of the questions based on the three-point Likert scale as follows:

The question is necessary

The question is useful but not necessary

The question is not necessary

Then, the following formula was used to calculate CVR:

CVR = (Ne − N/2)/ (N/2), (N: total number of experts, Ne: the number of experts who have chosen the “necessary” option.).

Based on the Lawshe table for minimum values of CVR, items with CVR equal to or greater than 0.99 were kept. To calculate the CVI, the experts determined the degree of relevance of each question on a 4-point Likert scale from not relevant to completely relevant. The following formula was used to decide about the acceptance of each question:

CVI: The number of experts who chose options 3 and 4 / the total number of experts. It was decided to reject or accept each question as follows: < 0.7 = rejected, 0.7–0.79 = revised, > 0.79 = accepted. The reliability of the questionnaire was calculated using Cronbach’s alpha and Guttman coefficient. Values greater than 0.7, 0.5–0.7, and less than 0.5 indicate high, acceptable, and low reliability of the questionnaire, respectively.

The third part of the questionnaire included open-ended questions. Two following questions were placed at the end of the questionnaire and were asked to the physicians:

In your opinion, what other advantages does this electronic prescribing system have?

In your opinion, what other challenges does this electronic prescribing system have?

Data collection

After the questionnaire was finalized, it was prepared in both paper and electronic formats. The electronic version of the questionnaire was prepared on the Porsline platform. For the survey, first, a list of physicians working in the teaching hospitals was prepared, and then we tried to get the contact numbers of the physicians as well. The questionnaire link was sent to physicians through the local social networks whose contact numbers were available, and physicians whose contact numbers were not available were referred to them in person. Many physicians refused to receive the questionnaire and answers due to lack of time. Two reminder messages were also sent to the doctors who had received the questionnaire link through social networks. In the face-to-face group, the doctors who did not have enough time to complete the questionnaire at that moment, the researcher provided the questionnaire to the physicians and coordinated with them to receive it at a later time. A total of 122 physicians agreed to participate in the study. It should be noted that to avoid missing data, it was mandatory to answer all the questions in the electronic questionnaire, and in the paper-based questionnaire, the researchers checked the questionnaire immediately, and if any fields were not completed, they asked the physicians to complete the incomplete items of the questionnaire again.

Data analysis

Descriptive statistics including mean, standard deviation, frequency median, interquartile range and percentage were used for data analysis.

The relationship of “sex,” “specialty,” “physician’s computer skills,” “age,” and “duration” with “satisfaction” was investigated. Since “satisfaction” is a qualitative ordinal variable, the Rank-biserial index was used to examine the relationship between this variable and two-level nominal variables such as “gender” and “specialty.” Kendall’s tau b index was also used to examine the relationship between “satisfaction” (ordinal variable) with rank variables such as “physician’s computer skills” and continuous quantitative variables such as “age” and “duration.” To investigate the relationship between “willingness to use paper-based or e-prescribing” with “sex,” “specialty,” “physician’s computer skills,” “age,” and “duration,” Phi, Rank-biserial, and Point-biserial were used respectively. The p -values obtained from the chi-square test were also reported to check the presence or absence of a relationship between two variables. The type I error in this study was considered 5%. Data analysis was carried out using SPSS version 26.

The answers given by 84 physicians to two open-ended questions were typed in Word.

Thematic analysis was used to analyze the open-ended questions and identify themes within qualitative data. For thematic analysis, first, the answers typed in the Word were imported into the ATLAS.ti software, and then the pattern extraction process was carried out according to the following steps:

The imported text was read several times to get familiar with the data

After familiarizing with the data, initial coding was done

After coding, the extracted codes were checked and revised many times

Similar codes were merged and grouped, and subthemes were created

Finally, the sub-themes were reviewed and linked, and the main themes were created

The designed questionnaire was given to 122 physicians, of which 84 physicians completed the questionnaires (response rate: 68.85%). Demographic characteristics of physicians are given in Table  1 . Most of the participants were general practitioners (56%) and women (53.6%). 91.7% of the physicians believed that they have medium and high computer skills and the average duration of using the e-prescribing system was 15.50 ± 8.798 months.

The results showed that the questionnaire had acceptable reliability (Cronbach’s alpha = 0.605, Guttman’s coefficient = 0.718). The mean (std. deviation), median and interquartile range of each question in the questionnaire are given in Table  2 . The questions were categorized into two sections: advantages and challenges of the e-prescribing system. The total mean score of advantages for the e-prescribing system was 2.15 and this value for challenges of this system was 2.75. Out of the advantages of this technology, the highest mean score (2.79) was related to the “E-prescribing system has reduced the possibility of wrong drug delivery due to illegible prescriptions” and the lowest (1.24) was related to the “The e-prescribing system has led to improved physician performance”. The most important challenge that physicians had with the e-prescribing system was the insufficient bandwidth with an average of 3.49. Two other challenges mentioned by physicians about this system and received a high mean score (3.43) were the challenges related to lengthening the duration of each visit and increasing the waiting time of patients.

The results of investigating the correlation between the duration of e-prescribing system use, age, sex, specialty, and the physician’s computer skills with the overall satisfaction with the e-prescribing system are reported in Table  3 . According to the results, 45 (53.6%), 32 (38.1%), and 7 (8.3%) physicians had low, medium and high overall satisfaction with this system, respectively. There was a statistically significant correlation between the sex and overall satisfaction with the e-prescribing system ( p -value = 0.009).

The results of the correlation between duration, age, sex, specialty, and the physician’s computer skills with the willingness to use paper-based prescribing or the e-prescribing system are reported in Table  4 . According to the results, 60 (71.4%) and 24 (28.6%) physicians preferred to use paper-based and e-prescribing respectively. There was a statistically significant correlation between the computer skill level and the prescribing methods ( P -value = 0.042).

The themes and sub-themes extracted from the question related to the advantages of the e-prescribing system are shown in Fig.  1 . The main themes of the e-prescribing system’s advantages were the following:

Process improvement

Economic efficiency

Enhance the accuracy of prescribing

These three themes included a total of 10 sub-themes.

Among the advantages noted for electronic prescribing, the possibility of editing prescriptions, providing different dosages of drugs, and the impossibility of manipulating prescriptions by patients or other people were mentioned more than other advantages. Also another mentioned advantage was the possibility of providing pre-prepared prescriptions for common diseases, which led to the acceleration of prescribing for these diseases.

Thematic map of concepts extracted from qualitative data related to the advantages of the e-prescribing system

Concepts related to the challenges of the e-prescribing system were categorized into five main themes as follows (Fig.  2 ):

Technical issues

Patient-related issues

Healthcare providers-related issues

Human resources challenges

Architectural and design issues

These five themes included more than 30 sub-themes.

Many challenges for electronic prescribing were mentioned in the form of given themes. One of the most important challenges mentioned by many physicians was various technical problems including network disconnection. Also, another big challenge that caused the dissatisfaction of the patients was the lack of skill of many physicians in working with computer systems, which led to the low speed of typing the drugs in the system and as a result, increased the duration of the patients’ visits. Also, many physicians did not have computer systems in their clinics, which led to the lack of electronic prescriptions and, as a result, the lack of use of insurance services for patients. Also, considering that many physicians are used to the paper prescription method, they were not willing to accept the changes and resisted these changes, as a result, they needed personnel to register the prescriptions.

Thematic map of concepts related to the challenges of the e-prescribing system

E-prescribing systems have many advantages, but they also pose certain challenges. These systems can enhance medication safety by reducing prescription errors caused by illegible handwriting or oral miscommunication. They can also improve efficiency by streamlining the prescription process, reducing the time spent on phone calls and faxes between healthcare providers and pharmacies. Furthermore, e-prescribing can provide clinicians with up-to-date information about patients’ medications and allergies, thereby improving patient care.

Although e-prescribing systems have many advantages, their implementation is not without any challenges. These include the costs associated with system implementation and maintenance, issues related to system interoperability, and the necessity for user training and technical support. Moreover, while these systems can mitigate traditional medication errors, they may also introduce new types of errors, such as those caused by user interface design or software glitches. Maximizing the benefits and minimizing the challenges associated with e-prescribing systems requires meticulous system design, comprehensive user training, and continuous system evaluation.

As demonstrated in the results section, the e-prescribing system’s mean overall benefit score was 2.15. This score suggests a moderate level of perceived benefits. It implies that while certain advantages are acknowledged, the system still needs to be improved to enhance user satisfaction and the perception of benefits. In this context, among the factors associated with the system’s benefits from the users’ perspective, the statements “Improved workflow has resulted from e-prescribing” and “The e-prescribing system has led to improved physician performance” received average scores of 1.48 and 1.24, respectively. These relatively low scores suggest that respondents of the survey or study largely disagree that the electronic system has enhanced their workflow or improved their performance. Several studies [ 11 , 12 , 26 , 27 ] have demonstrated that users do not concur that the use of prescribing systems leads to workflow improvement or performance enhancement. There are multiple possible reasons for this, including:

Usability issues: The e-prescribing system might not be user-friendly or intuitive, leading to difficulties in adoption among healthcare professionals.

Training and support: There might be a lack of adequate training and support for the users, making it challenging for them to adapt to the new system.

System limitations: The system might not be flexible enough to accommodate the diverse needs of different healthcare settings, leading to workflow inefficiencies.

Resistance to change: Healthcare professionals, like any other group, might resist changes to established routines. This resistance could affect their perception of the system’s benefits.

Among the challenges identified in the use of e-prescribing systems, the statement “Doctors have faced challenges with e-prescribing due to insufficient bandwidth” received the highest score of 3.49. According to this relatively high score, the survey or study respondents strongly agree that insufficient bandwidth has been a significant obstacle to the use of e-prescribing. This issue results in prolonged patient waiting times, leading to extended queues and a decrease in physician productivity. There are multiple factors that can cause insufficient bandwidth, such as:

Network Infrastructure: In areas with poor network infrastructure, insufficient bandwidth can significantly slow down the operation of e-prescribing systems, making it difficult for doctors to use them effectively.

System Requirements: To function optimally, e-prescribing systems may need a certain level of bandwidth. System lags or downtime could result if the available bandwidth is below this level.

Data Transfer: E-prescribing systems often need to transfer large amounts of data, including patient records, prescriptions, and other related information. Insufficient bandwidth can slow down this data transfer, affecting the system’s efficiency.

Real-time Updates: Many e-prescribing systems provide real-time updates to ensure that all users have the most current information. If there is not enough bandwidth, these updates can be delayed, resulting in potential errors or miscommunications.

Generally, as indicated by various studies [ 28 , 29 , 30 ], the implementation of e-prescribing systems requires robust hardware, sophisticated software, and a reliable network infrastructure. These elements are integral to the successful deployment and operation of such systems. According to this study, the hardware, software, and network infrastructure in Iran are not suitable for the implementation of e-prescribing systems. This inadequacy has caused increased challenges and dissatisfaction among users. Furthermore, our evaluation of physicians’ overall satisfaction with the e-prescribing system revealed that the majority, 45 (53.6%), had low satisfaction. Conversely, only a small proportion, 7 (8.3%), reported high satisfaction. Subsequently, the e-prescribing system is not widely accepted by users, with the majority (71.4%) favoring paper-based prescribing. Many other studies have indicated higher levels of user satisfaction and a greater willingness to accept and use e-prescribing systems, contrary to our study’s findings [ 31 , 32 , 33 , 34 ]. The low level of satisfaction and users’ reluctance to adopt the e-prescribing system can be attributed to various challenges and problems identified by them. Users have been greatly impacted by these issues, which range from technical difficulties to system design and architecture issues, resulting in dissatisfaction, diminished motivation, and resistance towards the system.

Although e-prescribing systems represent a novel and transformative approach in healthcare, they offer numerous benefits, including improved efficiency, reduced medication errors, and enhanced patient safety. However, our study highlights the presence of significant challenges, such as technical issues and problems related to system design and architecture, which result in low user satisfaction and hinder system adoption. The custodian and service provider organizations should upgrade the necessary information technology infrastructures, including hardware, software, and network infrastructures, to address the technical challenges. Furthermore, given that the design and architectural issues of the e-prescribing systems have resulted in user dissatisfaction and diminished motivation to use the system, identifying and addressing these problems and shortcomings in future updates is recommended. Moreover, it is important to take into account the end users’ perspectives during the system design process.

Data availability

All data generated or analyzed during this study are included within this article.

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Acknowledgements

This work was supported by a grant from Hamadan University of Medical Sciences Research Council (140206074578).

Author information

Soheila Saeedi and Taleb Khodaveisi contributed equally to this work.

Authors and Affiliations

Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Shahid Fahmideh Blvd, Hamadan, Iran

Hamid Bouraghi, Ali Mohammadpour, Soheila Saeedi & Taleb Khodaveisi

Department of Operating Room, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran

Behzad Imani

School of Medicine, Iran University of Medical Sciences, Tehran, Iran

Abolfazl Saeedi

Health Information Management Department, Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran

Tooba Mehrabi

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SS, TKH and HB developed the concept for the study. SS, TM, and AS collected data. SS and TKH carried out the analysis and interpretation under the supervision of HB and BI. Finally, SS, AM, AS, and HB drafted the manuscript. All authors reviewed the content and approved it.

Corresponding authors

Correspondence to Soheila Saeedi or Taleb Khodaveisi .

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Ethics approval and consent to participate.

The study was conducted in accordance with the Declaration of Helsinki and approved by a local ethics committee in Iran, namely Ethics Committee of the Hamadan University of Medical Sciences (IR.UMSHA.REC.1402.408). Verbal informed consent obtained from all the participants included in the study and was approved by the Ethics Committee of the Hamadan University of Medical Sciences.

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The authors declare no competing interests.

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Bouraghi, H., Imani, B., Saeedi, A. et al. Challenges and advantages of electronic prescribing system: a survey study and thematic analysis. BMC Health Serv Res 24 , 689 (2024). https://doi.org/10.1186/s12913-024-11144-3

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Received : 11 December 2023

Accepted : 23 May 2024

Published : 30 May 2024

DOI : https://doi.org/10.1186/s12913-024-11144-3

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