Marilyn Di Stefano, Wendy Macdonald; Australian Occupational Therapy Driver Assessors’ Opinions on Improving On-Road Driver Assessment Procedures. Am J Occup Ther 2010;64(2):325-335. doi: 10.5014/ajot.64.2.325.
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© 2019 American Occupational Therapy Association
OBJECTIVE. We collected practitioner opinions to improve the validity and reliability of the on-road driver assessment procedures used in Australia.
METHOD. We used focus groups to document the views of experienced occupational therapy driver assessors using a purposive sampling method.
RESULTS. Eight focus groups were conducted with 55 clinicians practicing in urban and rural regions. There was strong support for greater standardization of procedures for all tests. For drivers seeking unrestricted (open) licenses, use of standard routes with predetermined assessment points was important where practicable. Where use of a nonstandard route for this purpose was unavoidable, it was important to specify a minimum set of requirements related to route characteristics and assessment items.
CONCLUSION. Australian occupational therapy driver assessors support greater standardization of test routes and procedures to improve reliability and validity. However, the extent to which standardization can be achieved is limited by variable road traffic environments where assessments are conducted.
What do DTOTs see as the goals of their on-road assessment procedures?
Do DTOTs see a need for standardization of such procedures?
What factors do DTOTs see as limiting the real-world implementation of more standardized procedures?
What are DTOTs’ views on
Quite often … in the last 15 minutes of the assessment, I change my assessment to instruction [i.e., from performance assessment to driving instruction].… That gives you a better indication … [of whether] we go for a driving rehab program or … license cancellation.
I think those basic entry-level things are good … for client feedback so that you’ve got some concrete things to talk to them about … besides the OT stuff.
To fail them because they can’t reverse park a car when they’re 75 years old seems a bit silly … they stop at all stop signs … they’re doing good observations at pedestrian crossings and they know the speed limit round schools and different things. That’s more important.
I’ve referred several people back [elsewhere] because I just cannot get enough into a route for somebody who has high-level cognitive stuff going on. There’s just no way I’m “calling it” based on a town that has no traffic lights and just four square blocks and they’re all roundabouts.…
If you’ve got somebody that’s a long haul [truck] driver and has perhaps had an [acquired brain injury], we need to be looking at concentration. I’ve actually done 2-hour assessments because general feedback from family … health professionals … he just falls apart after an hour and a half, falls asleep … the assessment needs to be tailored.
A set sequence of procedures, including initial orientation, and then a familiarization driving period
Use of a standard route
Standard instructions to the driver
Set observations at set points along the route
Set pass–fail performance criteria
Use of normative data in evaluating performance criteria.
A hazard perception task requiring the driver to park the vehicle at the curb and describe hazards in the road environment
A task to assess memory/planning ability, in which they are instructed to “pull into the next petrol station that we come to and position the car beside a petrol bowser.”
You might go through a shopping center and nothing particularly untoward happens, so you’re not really sure whether the person has actually checked that pedestrian crossing or noticed that car pulling out. Whereas if [people are required to verbalize the kind of things they’re looking out for] it’s a way of confirming that even though they didn’t encounter it they actually were aware that it could happen.
We don’t drive up to a complex situation, stop, think about it and then drive into it. We actually encounter it in the middle of whatever’s happening.… It’s not something that we do naturally when we’re driving.
Being out on a freeway sometimes … when you’re just driving ahead at a reasonable speed [is] less demanding than when you’re having to go slow.… It might not necessarily be a speed factor [that determines demand]. It’s whether there’s other things going on as well.It would be dependent also on the task that they’ve been required to perform. So, if they’re in a low-demand environment but they’re self-navigating, that’s a higher cognitive demand than if they’re just following an instruction.
Being out on a freeway sometimes … when you’re just driving ahead at a reasonable speed [is] less demanding than when you’re having to go slow.… It might not necessarily be a speed factor [that determines demand]. It’s whether there’s other things going on as well.
It would be dependent also on the task that they’ve been required to perform. So, if they’re in a low-demand environment but they’re self-navigating, that’s a higher cognitive demand than if they’re just following an instruction.
Safety, safety, safety. I’d say it doesn’t really matter that they didn’t check their mirrors because there was nothing around but boy they missed that car that’s dangerous if they were in a four-lane carriageway or something.Planning, judgment, and observation.… They’re the heavy weights!
Safety, safety, safety. I’d say it doesn’t really matter that they didn’t check their mirrors because there was nothing around but boy they missed that car that’s dangerous if they were in a four-lane carriageway or something.
Planning, judgment, and observation.… They’re the heavy weights!
I think it’s a good idea.… We are constantly juggling this … how relevant was this mistake, how risky was that, how does that compare to the other? … the weighting is just going to help us categorize it a little bit more coherently.
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