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A randomised controlled trial to test the effectiveness of decision training on assessors’ ability to determine optimal fitness-to-drive recommendations for older or disabled drivers

机译:一项随机对照试验,用于测试决策者评估决策者是否有能力确定适合年长或残疾驾驶者的最佳驾驶建议的能力

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Driving licensing jurisdictions require detailed assessments of fitness-to-drive from occupational therapy driver assessors (OTDAs). We developed decision training based on the recommendations of expert OTDAs, to enhance novices’ capacity to make optimal fitness-to-drive decisions. The aim of this research was to determine effectiveness of training on novice occupational therapists’ ability to make fitness-to-drive decisions. A double blind, parallel, randomised controlled trial was conducted to test the effectiveness of decision training on novices’ fitness-to-drive recommendations. Both groups made recommendations on a series of 64 case scenarios with the intervention group receiving training after reviewing two thirds of the cases; the control group, at this same point, just received a message of encouragement to continue. Participants were occupational therapy students on UK and Australian pre-registration programmes who individually took part online, following the website instructions. The main outcome of training was the reduction in mean difference between novice and expert recommendations on the cases. Two hundred eighty-nine novices were randomised into intervention; 166 completed the trial (70 in intervention; 96 in control). No statistical differences in scores were found pre-training. Post training, the control group showed no significant change in recommendations compared to the experts (t(96)?=??.69; p?=?.5), whereas the intervention group exhibited a significant change (t(69)?=?6.89; p?
机译:驾驶执照管辖区要求职业治疗驾驶员评估师(OTDA)对驾驶健康进行详细评估。我们根据专业OTDA的建议进行了决策培训,以增强新手做出最佳驾驶适应性决策的能力。这项研究的目的是确定培训新手职业治疗师做出适应驾驶决定的能力的有效性。进行了一项双盲,平行,随机对照试验,以测试新手适应驾驶建议的决策训练的有效性。两组都对一系列64种情况提出了建议,干预组在审查了三分之二的案件后接受了培训;在同一时间,对照组刚刚收到了鼓励继续的信息。参加者是参加英国和澳大利亚预注册课程的职业治疗专业学生,他们按照网站的说明分别在线参加。培训的主要结果是减少了新手和专家对病例的建议之间的平均差异。 289名新手被随机分为干预组。 166人完成了试验(干预中70人,对照组96人)。训练前未发现分数的统计学差异。训练后,对照组的建议与专家相比没有显着变化(t(96)?= ?. 69; p?= ?. 5),而干预组的建议则有显着变化(t(69)??。5)。 = 6.89;p≤0.001。对于干预组,与专家建议相比,平均差异降低了95%CI,从?.13降至.09。训练后计算的效应大小显示出中等的效应(dδ= 0.69,rδ= 0.32)。接受了决策培训的新手可以更改他们的建议,而未接受培训的新手则不能。根据专家对相同案件的决定来衡量,那些接受培训的人变得更有能力识别不适合驾驶的驾驶员。这项研究表明,可以培训新手职业治疗师,使其决策与专业OTDA的决策更加一致。决策培训和案例已作为免费培训资源发布在www.fitnesstodrive.com上。新手驾驶员评估人员可以使用此方法来提高他们的技能,以识别在这个不断发展的实践领域中,是否适合驾驶的驾驶员,从而有可能增加国际劳动力的能力。

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