Revision and validation of the Australian Competency Standards for Occupational Therapy Driver Assessors to ensure best practice
- Authors: Fields, Sally
- Date: 2022
- Type: Text , Thesis , PhD
- Full Text:
- Description: Occupational therapy driver assessment and rehabilitation is an advanced and complex area of practice. Users of this service require that occupational therapy driver assessors are, and remain, competent in their role. Competency standards support and inform occupational therapy driver assessment and rehabilitation practice, ensure standardisation of practice, and determine whether practice can be deemed competent. Competency standards for occupational therapy driver assessors in one Australian state, Victoria, were published in 1998 to provide a benchmark for service provision and guide training. Since then, occupational therapy driver assessor practice has undergone further developments and growth, including a significant increase in research evidence underpinning this advanced practice area. As a result, the competency standards required revision to reflect contemporary practice and enable their use and application across all Australian states and territories. The purpose of the research program reported in this thesis was to revise and validate the Australian Competency Standards for Occupational Therapy Driver Assessors and determine if education and practice using these standards led to increased adherence to their use in clinical practice. A sequential, exploratory, mixed methods design was used within a pragmatist research paradigm to revise and validate the competency standards for occupational therapy driver assessors from a national perspective. Four separate research studies were conducted. In the first study, an overview was undertaken to summarise the current evidence for including cognitive and perceptual assessments within fitness-to-drive evaluations, to inform the revision of the competency standards for occupational therapy driver assessors. The second study involved focus groups with Australian occupational therapy driver assessors and expert educators and identified the changes and revisions required to be made to the Victorian competency standards for occupational therapy driver assessors. Content themes and changes were extracted from the focus groups and combined with research evidence to draft the revised standards. The third study collected feedback from consumers and Australian driver licensing authorities to incorporate into the revised draft. This was followed by a two-round Delphi process with Australian occupational therapy driver assessors to achieve consensus and validate the Australian Competency Standards for Occupational Therapy Driver Assessors. A high level of consensus on the content of all competency standards and underlying practice behaviours was obtained in the final round. Finally, a mixed-methods multiple case-study methodology was adopted, and multiple forms of evidence were collected from file audits, semi-structured interviews and an individualised education session with occupational therapy driver assessors. This study demonstrated that, for this sample, occupational therapy driver assessors’ adherence to the Australian Competency Standards for Occupational Therapy Driver Assessors increased following an individually tailored education package about the standards. The research in this thesis has contributed to the evidence base for occupational therapy driver assessor practice. The Australian Competency Standards for Occupational Therapy Driver Assessors have been revised, validated and published, and the impact of an education package to increase adherence has been investigated. These competency standards: (i) assist occupational therapy driver assessors’ clinical practice, support occupational therapy registration and regulatory agencies to evaluate practice against a standard and (iii) provide universities with a framework to deliver postgraduate training in occupational therapy driver assessment and rehabilitation. Finally, this research has described a process that can be utilised in other areas of occupational therapy practice to develop and validate competency standards.
- Description: Doctor of Philosophy
- Authors: Fields, Sally
- Date: 2022
- Type: Text , Thesis , PhD
- Full Text:
- Description: Occupational therapy driver assessment and rehabilitation is an advanced and complex area of practice. Users of this service require that occupational therapy driver assessors are, and remain, competent in their role. Competency standards support and inform occupational therapy driver assessment and rehabilitation practice, ensure standardisation of practice, and determine whether practice can be deemed competent. Competency standards for occupational therapy driver assessors in one Australian state, Victoria, were published in 1998 to provide a benchmark for service provision and guide training. Since then, occupational therapy driver assessor practice has undergone further developments and growth, including a significant increase in research evidence underpinning this advanced practice area. As a result, the competency standards required revision to reflect contemporary practice and enable their use and application across all Australian states and territories. The purpose of the research program reported in this thesis was to revise and validate the Australian Competency Standards for Occupational Therapy Driver Assessors and determine if education and practice using these standards led to increased adherence to their use in clinical practice. A sequential, exploratory, mixed methods design was used within a pragmatist research paradigm to revise and validate the competency standards for occupational therapy driver assessors from a national perspective. Four separate research studies were conducted. In the first study, an overview was undertaken to summarise the current evidence for including cognitive and perceptual assessments within fitness-to-drive evaluations, to inform the revision of the competency standards for occupational therapy driver assessors. The second study involved focus groups with Australian occupational therapy driver assessors and expert educators and identified the changes and revisions required to be made to the Victorian competency standards for occupational therapy driver assessors. Content themes and changes were extracted from the focus groups and combined with research evidence to draft the revised standards. The third study collected feedback from consumers and Australian driver licensing authorities to incorporate into the revised draft. This was followed by a two-round Delphi process with Australian occupational therapy driver assessors to achieve consensus and validate the Australian Competency Standards for Occupational Therapy Driver Assessors. A high level of consensus on the content of all competency standards and underlying practice behaviours was obtained in the final round. Finally, a mixed-methods multiple case-study methodology was adopted, and multiple forms of evidence were collected from file audits, semi-structured interviews and an individualised education session with occupational therapy driver assessors. This study demonstrated that, for this sample, occupational therapy driver assessors’ adherence to the Australian Competency Standards for Occupational Therapy Driver Assessors increased following an individually tailored education package about the standards. The research in this thesis has contributed to the evidence base for occupational therapy driver assessor practice. The Australian Competency Standards for Occupational Therapy Driver Assessors have been revised, validated and published, and the impact of an education package to increase adherence has been investigated. These competency standards: (i) assist occupational therapy driver assessors’ clinical practice, support occupational therapy registration and regulatory agencies to evaluate practice against a standard and (iii) provide universities with a framework to deliver postgraduate training in occupational therapy driver assessment and rehabilitation. Finally, this research has described a process that can be utilised in other areas of occupational therapy practice to develop and validate competency standards.
- Description: Doctor of Philosophy
- Fields, Sally, Unsworth, Carolyn
- Authors: Fields, Sally , Unsworth, Carolyn
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Australian Occupational Therapy Journal Vol. 64, no. 4 (2017), p. 328-339
- Full Text: false
- Reviewed:
- Description: Background/aim: Determination of fitness-to-drive after illness or injury is a complex process typically requiring a comprehensive driving assessment, including off-road and on-road assessment components. The competency standards for occupational therapy driver assessors (Victoria, Australia) define the requirements for performance of a comprehensive driving assessment, and we are currently revising these. Assessment of cognitive and perceptual skills forms an important part of the off-road assessment. The aim of this systematic review of systematic reviews (known as an overview) is to identify what evidence exists for including assessment of cognitive and perceptual skills within fitness-to-drive evaluations to inform revision of the competency standards. Methods: Five electronic databases (MEDLINE, CINAHL, PsycINFO, The Cochrane Library, OT Seeker) were systematically searched. Systematic review articles were appraised by two authors for eligibility. Methodological quality was independently assessed using the AMSTAR tool. Narrative analysis was conducted to summarise the content of eligible reviews. Results: A total of 1228 results were retrieved. Fourteen reviews met the inclusion criteria. Reviews indicated that the components of cognition and perception most frequently identified as being predictive of fitness-to-drive were executive function (n = 13), processing speed (n = 12), visuospatial skills, attention, memory and mental flexibility (n = 11). Components less indicative were perception, concentration (n = 10), praxis (n = 9), language (n = 7) and neglect (n = 6). Conclusion: This overview of systematic reviews supports the inclusion of assessment of a range of cognitive and perceptual skills as key elements in a comprehensive driver assessment and therefore should be included in the revised competency standards for occupational therapy driver assessors. © 2017 Occupational Therapy Australia
- «
- ‹
- 1
- ›
- »