A randomised controlled trial to test the effectiveness of decision training on assessors' ability to determine optimal fitness-to-drive recommendations for older or disabled drivers
- Harries, Priscilla, Unsworth, Carolyn, Gokalp, Hulya, Davies, Miranda, Tomlinson, Christopher, Harries, Luke
- Authors: Harries, Priscilla , Unsworth, Carolyn , Gokalp, Hulya , Davies, Miranda , Tomlinson, Christopher , Harries, Luke
- Date: 2018
- Type: Text , Journal article
- Relation: BMC Medical Education Vol. 18, no. 1 (2018), p.
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- Reviewed:
- Description: Background: Driving licensing jurisdictions require detailed assessments of fitness-to-drive from occupational therapy driver assessors (OTDAs). We developed decision training based on the recommendations of expert OTDAs, to enhance novices' capacity to make optimal fitness-to-drive decisions. The aim of this research was to determine effectiveness of training on novice occupational therapists' ability to make fitness-to-drive decisions. Methods: A double blind, parallel, randomised controlled trial was conducted to test the effectiveness of decision training on novices' fitness-to-drive recommendations. Both groups made recommendations on a series of 64 case scenarios with the intervention group receiving training after reviewing two thirds of the cases; the control group, at this same point, just received a message of encouragement to continue. Participants were occupational therapy students on UK and Australian pre-registration programmes who individually took part online, following the website instructions. The main outcome of training was the reduction in mean difference between novice and expert recommendations on the cases. Results: Two hundred eighty-nine novices were randomised into intervention; 166 completed the trial (70 in intervention; 96 in control). No statistical differences in scores were found pre-training. Post training, the control group showed no significant change in recommendations compared to the experts (t(96) = -.69; p =.5), whereas the intervention group exhibited a significant change (t(69) = 6.89; p < 0.001). For the intervention group, the mean difference compared with the experts' recommendations reduced with 95% CI from -.13 to.09. Effect size calculated at the post-training demonstrated a moderate effect (d =.69, r =.32). Conclusions: Novices who received the decision training were able to change their recommendations whereas those who did not receive training did not. Those receiving training became more able to identify drivers who were not fit-to-drive, as measured against experts' decisions on the same cases. This research demonstrated that novice occupational therapists can be trained to make decisions more aligned to those of expert OTDAs. The decision training and cases have been launched as a free training resource at www.fitnesstodrive.com. This can be used by novice driver assessors to increase their skill to identify drivers who are, and are not fit-to-drive, potentially increasing international workforce capacity in this growing field of practice. © 2018 The Author(s).
- Authors: Harries, Priscilla , Unsworth, Carolyn , Gokalp, Hulya , Davies, Miranda , Tomlinson, Christopher , Harries, Luke
- Date: 2018
- Type: Text , Journal article
- Relation: BMC Medical Education Vol. 18, no. 1 (2018), p.
- Full Text:
- Reviewed:
- Description: Background: Driving licensing jurisdictions require detailed assessments of fitness-to-drive from occupational therapy driver assessors (OTDAs). We developed decision training based on the recommendations of expert OTDAs, to enhance novices' capacity to make optimal fitness-to-drive decisions. The aim of this research was to determine effectiveness of training on novice occupational therapists' ability to make fitness-to-drive decisions. Methods: A double blind, parallel, randomised controlled trial was conducted to test the effectiveness of decision training on novices' fitness-to-drive recommendations. Both groups made recommendations on a series of 64 case scenarios with the intervention group receiving training after reviewing two thirds of the cases; the control group, at this same point, just received a message of encouragement to continue. Participants were occupational therapy students on UK and Australian pre-registration programmes who individually took part online, following the website instructions. The main outcome of training was the reduction in mean difference between novice and expert recommendations on the cases. Results: Two hundred eighty-nine novices were randomised into intervention; 166 completed the trial (70 in intervention; 96 in control). No statistical differences in scores were found pre-training. Post training, the control group showed no significant change in recommendations compared to the experts (t(96) = -.69; p =.5), whereas the intervention group exhibited a significant change (t(69) = 6.89; p < 0.001). For the intervention group, the mean difference compared with the experts' recommendations reduced with 95% CI from -.13 to.09. Effect size calculated at the post-training demonstrated a moderate effect (d =.69, r =.32). Conclusions: Novices who received the decision training were able to change their recommendations whereas those who did not receive training did not. Those receiving training became more able to identify drivers who were not fit-to-drive, as measured against experts' decisions on the same cases. This research demonstrated that novice occupational therapists can be trained to make decisions more aligned to those of expert OTDAs. The decision training and cases have been launched as a free training resource at www.fitnesstodrive.com. This can be used by novice driver assessors to increase their skill to identify drivers who are, and are not fit-to-drive, potentially increasing international workforce capacity in this growing field of practice. © 2018 The Author(s).
Linking people and activities through community mobility : an international comparison of the mobility patterns of older drivers and non-drivers
- Unsworth, Carolyn, Dickerson, Anne, Gélinas, Isabelle, Harries, Priscilla, Margot-Cattin, Isabel, Mazer, Barbara, Stapleton, Tadhg, Swanepoel, Lizette, Timmer, Amanda, Niekerk, Lana, Vrkljan, Brenda
- Authors: Unsworth, Carolyn , Dickerson, Anne , Gélinas, Isabelle , Harries, Priscilla , Margot-Cattin, Isabel , Mazer, Barbara , Stapleton, Tadhg , Swanepoel, Lizette , Timmer, Amanda , Niekerk, Lana , Vrkljan, Brenda
- Date: 2022
- Type: Text , Journal article
- Relation: Ageing and Society Vol. 42, no. 8 (2022), p. 1938-1963
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- Description: Community mobility using private and public transportation is important for maintaining health, social participation and living well in later life. This international cross-sectional cohort study (N = 246) reported on the health and driving status of older adults from seven countries where the mobility patterns of drivers and non-drivers were compared in terms of city and rural areas, weather, as well as their respective differences in the number of out-of-home places accessed and quality of life. Older adults participated in a semi-structured interview and completed four standardised instruments: the EQ-5D-5L, modified PULSES health profile, modified Transportation Questionnaire, and the Transport - Participation in Activities and Places Outside the Home. Results suggested inclement weather and place of residence negatively impacted out-of-home activities but did not increase use of public transportation. Drivers accessed more out-of-home activities than non-drivers, suggesting higher community participation among this group, and quality of life was generally high among all participants, but slightly higher for drivers. Findings indicate that a complex myriad of factors can influence community mobility in older adults and further investigations are needed to understand patterns of transport in later life, particularly with regard to those factors that promote and maintain transport mobility, and relationships between transport mobility, community participation and quality of life. Copyright © The Author(s), 2021. Published by Cambridge University Press.
- Authors: Unsworth, Carolyn , Dickerson, Anne , Gélinas, Isabelle , Harries, Priscilla , Margot-Cattin, Isabel , Mazer, Barbara , Stapleton, Tadhg , Swanepoel, Lizette , Timmer, Amanda , Niekerk, Lana , Vrkljan, Brenda
- Date: 2022
- Type: Text , Journal article
- Relation: Ageing and Society Vol. 42, no. 8 (2022), p. 1938-1963
- Full Text:
- Reviewed:
- Description: Community mobility using private and public transportation is important for maintaining health, social participation and living well in later life. This international cross-sectional cohort study (N = 246) reported on the health and driving status of older adults from seven countries where the mobility patterns of drivers and non-drivers were compared in terms of city and rural areas, weather, as well as their respective differences in the number of out-of-home places accessed and quality of life. Older adults participated in a semi-structured interview and completed four standardised instruments: the EQ-5D-5L, modified PULSES health profile, modified Transportation Questionnaire, and the Transport - Participation in Activities and Places Outside the Home. Results suggested inclement weather and place of residence negatively impacted out-of-home activities but did not increase use of public transportation. Drivers accessed more out-of-home activities than non-drivers, suggesting higher community participation among this group, and quality of life was generally high among all participants, but slightly higher for drivers. Findings indicate that a complex myriad of factors can influence community mobility in older adults and further investigations are needed to understand patterns of transport in later life, particularly with regard to those factors that promote and maintain transport mobility, and relationships between transport mobility, community participation and quality of life. Copyright © The Author(s), 2021. Published by Cambridge University Press.
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