Using Social Judgment Theory method to examine how experienced occupational therapy driver assessors use information to make fitness-to-drive recommendations

INTRODUCTION

As people with a range of disabilities strive to increase their community mobility, occupational therapy driver assessors are increasingly required to make complex recommendations regarding fitness-to-drive. However, very little is known about how therapists use information to make decisions. The aim of this study was to model how experienced occupational therapy driver assessors weight and combine information when making fitness-to-drive recommendations and establish their level of decision agreement.

METHOD

Using Social Judgment Theory method, this study examined how 45 experienced occupational therapy driver assessors from the UK, Australia and New Zealand made fitness-to-drive recommendations for a series of 64 case scenarios. Participants completed the task on a dedicated website, and data were analysed using discriminant function analysis and an intraclass correlation coefficient.

RESULTS

Accounting for 87% of the variance, the cues central to the fitness-to-drive recommendations made by assessors are the client's physical skills, cognitive and perceptual skills, road law craft skills, vehicle handling skills and the number of driving instructor interventions. Agreement (consensus) between fitness-to-drive recommendations was very high: intraclass correlation coefficient = .97, 95% confidence interval .96-.98).

CONCLUSION

Findings can be used by both experienced and novice driver assessors to reflect on and strengthen the fitness-to-drive recommendations made to clients.

Knowledge and attitudes of occupational therapists to giving advice on fitness to drive

Introduction

A range of medical conditions can affect driving, and health professionals should advise patients accordingly. This study examined the knowledge of occupational therapists, other therapists and psychologists regarding medical standards for driving, their attitudes to advising patients about driving, and barriers to giving that advice.

Method

A structured questionnaire measured knowledge of medical standards and attitudes to advising patients about driving. Analyses compared responses of occupational therapists with those of other therapists and psychologists. Semi-structured interviews were carried out with therapists and psychologists after they had watched a video-taped clinical consultation with an actor–patient who was unfit to drive. Interviewees, unaware that the study was about driving, were asked how they would advise the patient. Focus groups were held with a range of health professionals to discuss facilitators and barriers to giving driving advice.

Results

Eighty-two questionnaires were completed. Occupational therapists were most aware of driving guidelines and most likely to advise patients to stop driving ( p < 0.01). A total of 98% of occupational therapists believed they should discuss driving compared with 68% of other therapists and psychologists ( p < 0.01). Therapists were more likely than psychologists to spontaneously raise the issue of driving after viewing the video-consultation.

Conclusion

Occupational therapists are well placed to expand their role in advising patients about fitness to drive. For this they require additional training and clarification of their role and legal responsibilities.