RT Journal Article SR Electronic T1 Evidence and speculation: reimagining approaches to architecture and research within the paediatric hospital JF Medical Humanities JO J Med Humanit FD BMJ Publishing Group Ltd and Institute of Medical Ethics SP medhum-2017-011285 DO 10.1136/medhum-2017-011285 A1 Rebecca McLaughlan A1 Alan Pert YR 2017 UL http://mh.bmj.com/content/early/2017/11/25/medhum-2017-011285.abstract AB As the dominant research paradigm within the construction of contemporary healthcare facilities, evidence-based design (EBD) will increasingly impact our expectations of what hospital architecture should be. Research methods within EBD focus on prototyping incremental advances and evaluating what has already been built. Yet medical care is a rapidly evolving system; changes to technology, workforce composition, patient demographics and funding models can create rapid and unpredictable changes to medical practice and modes of care. This dynamism has the potential to curtail or negate the usefulness of current best practice approaches. To imagine new directions for the role of the hospital in society, or innovative ways in which the built environment might support well-being, requires a model that can project beyond existing constraints. Speculative design employs a design-based research methodology to imagine alternative futures and uses the artefacts created through this process to enable broader critical reflection on existing practices. This paper examines the contribution of speculative design within the context of the paediatric hospital as a means of facilitating critical reflection regarding the design of new healthcare facilities. While EBD is largely limited by what has already been built, speculative design offers a complementary research method to meet this limitation.