Examining Occupational Therapists' Awareness of Medical Fitness-to-Drive Legislation Using a Knowledge-to-Action Approach

Abstract

One Canadian province now requires occupational therapists (OTs) to report medically at-risk drivers to the transportation authority. This study examined OTs' legal and professional responsibilities with regard to medical fitness to drive. Two knowledge translation models guided the study design. Semi-structured interviews were conducted with 7 OTs, a geriatrician, as well as representatives from professional regulatory organizations and the licensing bureau. Emergent themes highlight gaps in the translation of knowledge specific to professional responsibilities as well as ethical risks to client rapport. Further education on relevant policies is suggested and changes to existing resources that support clinical practice.

Addressing Driving in Acute Care: Perceived Relevance and Competence

“…Occupational therapists also reported professional tensions within interdisciplinary teams when addressing driving (Sangrar et al, 2018). Therapists shared the challenges experienced when navigating differences in opinion for fitness to drive with physicians.…”

“…Given the breadth of settings in which occupational therapists are employed, it is a priority to understand driving within specific practice areas and contexts (Sangrar et al, 2018). Acute care hospitals pose a unique challenge for addressing driving.…”

“…These findings are similar to those reported in a recent study undertaken shortly after the introduction of discretionary reporting 2 for Ontario occupational therapists. From their interviews, Sangrar et al (2018) found that therapists remain uncertain of legislation and licensing policies and procedures for medically at-risk drivers and their role in medical fitness to drive. Occupational therapists also expressed concern that addressing driving can jeopardize the therapeutic relationship and even fear clients may seek legal action against the therapist for reporting a driver to the ministry (Sangrar et al, 2018).…”

“…Therapists shared the challenges experienced when navigating differences in opinion for fitness to drive with physicians. They also described one-sided approaches in which a physician deferred the decision solely to the occupational therapist to “clear the [client] to drive” (Sangrar et al, 2018, p. 278). Furthermore, occupational therapists expressed concern regarding physicians using occupational therapy assessment results outside of their intended purpose to justify a report to licensing authorities.…”

“…Furthermore, occupational therapists expressed concern regarding physicians using occupational therapy assessment results outside of their intended purpose to justify a report to licensing authorities. For example, a client may have consented to a cognitive assessment without the knowledge that the physician could use the results to initiate a report to the ministry (Sangrar et al, 2018). These findings underscore the practical, ethical, and professional challenges for addressing driving and highlight the need for more research to support competency development of occupational therapists in this area.…”