Revision of the Competency Standards for Occupational Therapy Driver Assessors: An overview of the evidence for the inclusion of cognitive and perceptual assessments within fitness‐to‐drive evaluations

Fields, Sally M.; Unsworth, Carolyn

doi:10.1111/1440-1630.12379

Cited by 11 publications

(7 citation statements)

References 86 publications

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“…Occupational therapy driver assessor practice across Australia is diverse, with a review of off-road assessments including 20 tests that may be completed by occupational therapists (Unsworth et al, 2005). A recent overview by Fields and Unsworth (2017) summarised the evidence for including cognitive and perceptual assessments within occupational therapy driver assessments, recommending multiple components of cognition and perception are assessed, which was supported in the results in phase 1 (Quote 4) and has been incorporated into the revised competency standards. Both phases identified that the timing and types of assessments and processes undertaken are related to the context and jurisdiction in which the occupational therapy driver assessor practises, and the training course undertaken.…”

Section: Flexibility and Clinical Reasoningmentioning

confidence: 99%

The revision of competency standards for occupational therapy driver assessors in Australia: A mixed methods approach

Fields

Unsworth

Harreveld

2021

Aus Occup Therapy J

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Introduction: Competency standards outline the knowledge, skills, and attributes that are required for competent practice. This study describes the process followed to revise and validate the competency standards for occupational therapy driver assessors in order to guide clinical practice in this area of advanced occupational therapy practice. Methods: A mixed methods research approach was used in this study. In phase 1, three focus groups with driver assessors reviewed and suggested revisions to the competency standards for occupational therapy driver assessors. Phase 2 involved content validation with key stakeholders through a focus group with consumers, written feedback from Australian state, and territory driver licensing authorities, and a two-round Delphi process with Australian occupational therapy driver assessors. Results: Forty-nine occupational therapy driver assessors participated in the phase 1 focus groups. Deductive content analysis of the transcripts provided data to revise the competency standards. Inductive analysis provided an in-depth understanding of the participants' views and was interpreted through six categories and their underlying subcategories: purposes and benefits; jurisdictional variations and practice diversity; language use; defining competent practice; challenging systems and processes; and competency standards content. Forty-eight occupational therapy driver assessors participated in the Delphi process. In Round 1, only 1 of the 164 competency standards and practice behaviours rated did not achieve the pre-determined 70% consensus rate. In Round 2, all statements achieved consensus, with the overall average consensus level obtained across the Round 2 statements at 96.8%. Conclusion:The revised Australian Competency Standards for Occupational Therapy Driver Assessors have been endorsed by Occupational Therapy Australia and released for clinical use. The methods described in this research provide a framework suitable for revision or development of competency standards in both other areas of occupational therapy practice and other health-care professions.

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Section: Flexibility and Clinical Reasoningmentioning

confidence: 99%

The revision of competency standards for occupational therapy driver assessors in Australia: A mixed methods approach

Fields

Unsworth

Harreveld

2021

Aus Occup Therapy J

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“…All occupational therapists have ethical obligations to address all aspects of community mobility, including driving (Fields & Unsworth, 2017;Occupational Therapy Australia, 2015). Previous research to address driving within non-OTDA practice has identified gaps in clinical competence among Canadian clinicians (Korner-Bitensky et al, 2010) and reduced confidence among Irish and American clinicians Stack et al, 2018).…”

Section: | Introductionmentioning

confidence: 99%

Fitness to drive practices among non‐driver trained occupational therapists in an Australian community‐based rehabilitation setting

Scott

Unsworth

Browne

2021

Aus Occup Therapy J

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Introduction: Driving is a valued occupation given the independence and freedom it provides. Safe driving performance can be impacted by medical conditions, change in functional status and ageing processes. Occupational therapy driver assessors (OTDAs) provide invaluable driving recommendations; however, this requires specialist training for the therapist and is costly for clients. The number of OTDAs is not expected to meet the growing demand for expert services in this area, and little is known about the practices that non-OTDAs use to assist clients with returning to driving. The aims of this study were to investigate the practices of non-OTDAs in a community-based rehabilitation setting in Australia with respect to knowledge, confidence and skills in assessments, recommendations and outcomes for clients as part of the return to driving process. Methods: A descriptive study including medical record audits between April and September 2019 and staff surveys were completed at a large metropolitan communitybased rehabilitation facility. Descriptive statistics and thematic analysis were used to summarise data. Results: A total of 102 client medical records were audited, and 13 clinician surveys were completed. Medical record audits identified that return to driving was not consistently addressed by occupational therapists. Clinician surveys outlined a lack of knowledge and confidence of return to driving processes and available assessment tools to guide this process. Conclusion: All occupational therapists have an ethical obligation to address driving as an activity of daily living; however, non-OTDAs report that they are not equipped for this role. This may negatively impact on driver safety, independence and overall health and well-being of clients in community-based rehabilitation. Further research is indicated to develop evidence-based driving resources to support best practice of non-OTDAs.

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“…Strategic decisions are made before driving commences, whereas tactical and operational decisions require information about the immediate driving situation and are thus made in real time. The interaction of several cognitive abilities is required, especially at the tactical level, for which the most important factors for predicting motor vehicle collisions have been found to be executive function; focused, sustained, divided and selective attention; visuospatial function; decision-making; processing speed and memory (Field and Unsworth, 2017; Hird et al., 2016; Lafont et al., 2008; Seong-Youl et al., 2014). The planning or strategic level is the most difficult level to assess in a standardised way, because it concerns mainly evaluation of the risks involved and avoiding risks before the driver sits behind the wheel.…”

Section: Introductionmentioning

confidence: 99%

Decisions on driving after brain injury/disease: Feasibility and construct validity of a new simulator assessment tool

Samuelsson

Wressle

2020

British Journal of Occupational Therapy

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Introduction Driving is a complex activity involving a high level of cognitive abilities and thus might be affected after a brain injury/disease. The aim of this research was to evaluate the feasibility and construct validity of a driving simulator tool as a complement to existing driving assessments of patients with cognitive dysfunctions after a brain injury/disease. Method A descriptive and prospective research design was achieved. For construct validation, decisions were based on results from the Useful Field of View, Nordic Stroke Driver Screening Assessment, Trail Making Test and, when necessary for the decision, an on-road observation. Results from the simulator tool were not included in the clinical decision process. Results A total of 129 patients from four different rehabilitation services were included. The results showed a significant difference in test results between those who were considered medically fit versus unfit to drive. A factor analysis revealed four components, all including attention in combination with processing speed, visuospatial function, simultaneous capacity and executive function; these are all represented in the simulator tool. A correlation analysis showed that simulator subtest 3 (response/divergent response to stimuli) had the strongest correlation with most of the other tests included. Conclusions The simulator was found to be feasible and valid and found to include components other than those measured in the other tests.

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Revision of the Competency Standards for Occupational Therapy Driver Assessors: An overview of the evidence for the inclusion of cognitive and perceptual assessments within fitness‐to‐drive evaluations

Abstract: 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.

Cited by 11 publications

References 86 publications

The revision of competency standards for occupational therapy driver assessors in Australia: A mixed methods approach

The revision of competency standards for occupational therapy driver assessors in Australia: A mixed methods approach

Fitness to drive practices among non‐driver trained occupational therapists in an Australian community‐based rehabilitation setting

Decisions on driving after brain injury/disease: Feasibility and construct validity of a new simulator assessment tool

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