Evaluation of curriculum to improve health professionals' ability to manage age-related driving impairments

摘要

As our elderly population increases in proportion with respect to the rest of society, age-related driving impairments are increasing in importance as a public health concern. In this context, health professionals play an important role in identifying impaired drivers. This situation is complicated for two reasons: discussion of driving cessation is a sensitive topic for both health professionals and the elderly, and physicians have limited familiarity with the current American Medical Association (AMA) screening guidelines or mandated reporting laws. To assess curriculum that trains health professionals to increase their awareness, screening, management, and reporting of age-related driving impairments. Between 2009 and September 2011, 47 trainings were delivered to 1202 health professionals. The majority of trainings were seminars or lectures lasting 1 h; all were conducted in southern California. The training curriculum was divided into four sections: introduction and background; screening and interpretation; managing outcomes and reporting; and referrals and resources. Videos addressed broaching the topic with patients and counseling on driving cessation. The curriculum was delivered by physicians with the support of public health-trained program staff. Pre- and post-testing was done with 641 of the participants; the majority were physicians. Post-training, participants' confidence in ability to screen increased to 72% and intent to screen increased to 55%. Fully 92% stated they had developed a better understanding of California's mandated reporting laws. Similarly, 92% said they had developed a better understanding of the medical conditions and medications that may impair older adults' ability to drive safely. Furthermore, 91% said mandated-reporting laws helped protect the safety of patients and others, and 59% said it was easier to discuss and justify driving cessation with patients. In-person training of health professionals on age-related driving impairments was well received and resulted in increased self-reported knowledge, confidence to screen, and intent to screen. Physicians were supportive of mandatory reporting laws.