OT assessments of medically impaired drivers: Understanding the practice context to optimise referral of at-risk drivers and testing procedures
Licence review systems often rely on occupational therapists (OTs) trained in driver assessment to identify medically at-risk drivers and conduct on-road driver testing. The need to better understand these professionals and their contribution to road safety has been identified; little research investigating OT practice has been conducted internationally. The researchers sought to understand OT on-road testing: practice issues, driver characteristics, test improvements and views regarding client and health professional education. An initial focus group with experienced OTs confirmed key issues subsequently incorporated into an on-line questionnaire. All OTs practising in the jurisdiction were invited to complete the survey. Descriptive statistics were generated from fixed response items and themes were extracted from qualitative data. Fifty seven OTs responded: one third had 10 or more years of experience and had conducted 500+ assessments. OT clients tended to be older fully licensed drivers, with complex medical/disability issues often involving cognition. Priority road safety education interventions confirmed targeting GPs, carers and drivers with dementia. Whilst OTs routinely used documented standard on-road routes and managed testing risks, they identified additional training needs relating to test procedures and other licensing options. Internet based surveys used as part of a participatory research model actively engaged OTs in establishing road safety priorities. Results will be used to enhance (i) the identification of at-risk drivers, and (ii) development of clearer on-road test guidelines including pass-fail and route criteria to improve test validity and reliability.