Best Practices in Nursing School Design: Flexible and Adaptable Learning Environments

Ayers Saint Gross designs top-tier spaces to support educating nurses equipped to handle the future as healthcare delivery systems continue to transform. This two-part series dives into the influences that are changing the way nursing students learn and the way nursing faculty teach. Read Part 2. 

Flexible and Adaptable Learning Environments
Our allied health projects have flexibility embedded in the planning and organization of the spaces. Spaces that adapt to evolving methodology is essential as pedagogy, technology, healthcare demand, and specialized care needs shift. A well-designed building can be the framework that allows a program to endure changes and remain at the forefront of educating the modern workforce. 

Creative and thoughtful design ensures clinical learning environments are both flexible (easily modified) and adaptable (able to serve a new use), while leveraging synergies and shared resources to maximize efficiencies. Considerate yet simple diagrams communicate the specific departmental aspects while illustrating where overlap exists and are the parti that translate into practical space layouts. 

Working with Frostburg State University, Ayers Saint Gross devised a concept to meet long-term goals for the Department of Nursing while adhering to the programmed space allocation. The inaugural Nursing program growth had surpassed the initial concepts outlined in the Part II program and future degree offerings necessitated a greater variety of space types. Understanding their drivers, we conceived two versions of an open skills lab that could also function as four dedicated simulation labs. Key adjacency to a flexible classroom essentially acts as a flex space to serve three functions: (1) a fully functional classroom, (2) a clinical learning class lab facilitating skills instruction and demonstration on the classroom side and hands-on implementation on the adjacent bays, and (3) a generous footprint for future simulation lab growth and program expansion. Providing a heightened level of flexibility with operable walls, mobile equipment, etc., allows instructors freedom to be creative in imagining scenarios. 

As the healthcare delivery models evolve, Interprofessional Education (IPE) is becoming indispensable to modern health professions for the value it brings to education – providing hands-on collaborative clinical learning where students apply critical thinking to learn about and communicate with other disciplines in a safe environment. Initial space planning design should consider how the learning environments perform and transform to allow for a multitude of IPE scenarios and an influx of students and faculty from other health professions programs. 

During design for the Auburn University School of Nursing, there was a distinct adjacency established between the large active learning classrooms, the building commons, and the outdoor greenspace for opportunities to host a variety of events. One success of this concept was realized during their inaugural Disaster Day Drill IPE event where Nursing and Osteopathic medicine students worked together to triage and treat patients in a large-format simulation. This scale and realism would not have been possible without Auburn and Ayers Saint Gross’s close collaboration and holistic approach to designing a building equipped to do more than standard skills training and instruction. The green space was transformed into triage spaces filled with simulated victims to be evaluated by the practicing students and the buildings’ EAGLES Center was transformed into the simulated hospital ER. “During the disaster drill, this spacious simulation area allowed for a total of 48 patients with 32 utilizing beds and 12 seated in chairs. The simulation area was divided into four “pods,” which acted as four separate hospital emergency departments.” Notably, the realism of this event prepared the osteopathic medical students to be tested for their Basic Disaster Life Support certification. The finale to the drill concluded in the dividable, flexible active learning classroom for a comprehensive group debrief. 

As a formal learning environment, this space integrates technology and team-based learning, while also being flexible enough to test new pedagogies. A vertically folding operable partition expands the teaching environment to support a range of clinical learning scenarios. Down the hall, two collaborative tiered lecture classrooms allow for multiple learning arrangements, live demonstrations, and remote broadcasting. 

Faculty and students acclaim that the new nursing building brings them together and note the impact of active learning environments being a “critical part of nursing education… specifically tailored to provide the necessary resources.” The space for informal learning, outside the classroom, was equally important to consider as classes scheduled in long segments necessitate spaces to inhabit during breaks. To maximize these options, the traditional prebrief and debrief rooms embedded in the simulation suite serve during off-hours as private or group study rooms. Occupants find that these spaces (with great daylight and views to campus) encourage faculty and students to engage for day-to-day interaction, capstone projects, and student organization meetings that supplement nursing training, such as global health initiative trips. 

Ayers Saint Gross has designed three phases for Duke University’s School of Nursing. The Physical Therapy /School of Nursing Education Building bridges to the School of Nursing, continuing the expansion and consolidation of the school’s programs under one roof. The design team and user group worked extensively to conceive adaptable and flexible learning environments to meet their needs, focusing on strategies to mitigate resources taxed by the influx of distance learners during On-Campus Intensives. The design for a typical active learning classroom was adapted into three collaborative seminar spaces to supplement clinical learning, host workshops, and enable development in a state-of-the art learning environment. 

The concept Ayers Saint Gross developed for Duke’s Standardized Patient Suite follows suit with maximizing adaptability and space utility. An “ante room” functions for charting, observation, post-exam evaluation, reflection, and as the separate entrance for the student or patient actor. The exam room side is fit out for a patient actor connected to a dedicated lounge and entry zone. Exam rooms are integrated with A/V capabilities and can also function for high-fidelity simulation utilizing a manikin. 

Flexibility and adaptability are crucial, but these concepts are just the beginning. Join us for our next entry as we illustrate the importance and value of integrating wellness and community outreach into the design of nursing and health professions programs. 

Laura White, AIA, LEED AP BD+C, WELL AP is an associate principal based out of the Baltimore office.