I really don't like the feeling of leaving an elevator and not knowing whether to go left or right. You need to be moving so you don't bother the people behind you, but if you just pick a direction you might be going completely the wrong way. My sense of direction is pretty good outside but inside it's patchy, effectively on a floor-by-floor basis.
A few months ago I realized that while waiting for the elevator I can generally work out which way I'll want to walk when I get off. I don't have anything else to do while waiting, so it's a nice short puzzle. Once I figure it out I stand on the side of the elevator opposite where I intend to get out, and maintain that inside the car. When I get to the top I know which way to go from where I'm standing, in case I forgot on the way up, and I go from 50% success in leaving pointing the right way to ~95%.